Renal effects of cyclo-oxygenase-2 inhibition

SUMMARY: The renal cyclo-oxygenase (COX)-2 isoenzyme has an important role in the maintenance of renal homeostasis, particularly in the setting of reduced renal perfusion. Selective inhibition of COX-2 in the kidney has significant effects on renal physiology, most marked when COX-2 expression is induced. the clinical risk of renal impairment, salt and water retention, and electrolyte disturbance should be considered carefully when prescribing a COX-2 inhibitor in this setting.