Migraine is a common headache disorder that causes significant disability. Ketoprofen is one of the world's most widely-prescribed NSAIDs for treatment of headaches. Piroxicam is another NSAID that was approved in the last several years, with different mechanisms of action on cyclooxygenase inhibition. Theoretically, this approach can lead to various adverse effects on the kidneys. Relatively, little is known about comparative nephrotoxicity of NSAIDs. Therefore, the present study was designed to compare the adverse renal effects, of Ketoprofen and Piroxicam in patients with headaches.
We used venous urine and blood from cephalic-migraine in 10 patients treated with Ketoprofen with a total dose of up to 100 mg per day, and 10 with Piroxicam 20 mg after 12 months of therapy, patients in comparison with the control group of examinees. Besides conventional markers of renal function (serum/urine creatinin determined by Jaffe methods enzymatic assay for urea in serum), we used nephelometry by β2 Microgloglobulin (β2 M) and photoelectric colorimetry for microalbuminuria in urine, to monitor glomerular and tubular functioning. Any history of kidney disease was exclusion criteria to enter the study.
The standard metrics to follow the progression of AKI, like serum creatinine and blood urea levels, are inconvenient and depend on kidney injury. That’s why we must use specific markers for early detection. Following the levels of specific biomarkers in urine we can use them as signals for early detection of nephrotoxicity, we can recommend constant monitoring of renal functions during use of different groups of NSAIDs and be careful while using analgesic -anti-inflammatory drugs.
Keywords: adverse renal effects, non-steroidal anti-inflammatory drugs, migrain
