The effect of nonsteroidal antiinflammatory drugs on electrolyte homeostasis and blood pressure in young and elderly persons with and without renal insufficiency

Michael D. Murray, Emmanuel N. Lazaridis, Edward Brizendine, Kathy Haag, Paula Becker, D. Craig Brater

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The study objective was to determine the acute and long-term effects of nonsteroidal antiinflammatory drugs (NSAIDs) on the excretion of sodium and potassium, blood pressure, and body weight in young and elderly persons without renal insufficiency, and in elderly persons with moderate renal insufficiency. We conducted a randomized, open-label, three-way, crossover study in which subjects were administered 800 mg ibuprofen three times daily, 20 mg piroxicam daily, and 200 mg sulindac twice daily. Measurements included clearance and balance studies of the excretion of sodium and potassium during a 24-hour period, sitting systolic and diastolic blood pressures, and body weight measurements. Ibuprofen, piroxicam, and sulindac reduced excretion of sodium and potassium. Maximum decrements in the fractional excretion of sodium and potassium were significant for all NSAIDs in each group (P < 0.05). Change in blood pressure was greater with ibuprofen than sulindac both for systolic blood pressure (mean difference ± standard error of mean, 9.7 ± 2.3 mm Hg, P = 0.0002) and diastolic blood pressure (mean difference, 6.0 ± 1.6 mm Hg, P = 0.005). Blood pressure increase was associated inversely with sodium excretion after 1 month of NSAID administration (P = 0.032). Blood pressures increased for elderly persons with renal insufficiency with the administration of ibuprofen. Ibuprofen increased body weight in young persons (P = 0.006) and in persons with renal insufficiency (P = 0.01), and piroxicam increased weight in elderly persons without renal insufficiency. No weight increase was observed with sulindac. We conclude that ibuprofen, piroxicam, and sulindac all reduce urinary excretion of sodium and potassium in young and elderly persons independently of their level of renal function. Ibuprofen elevates blood pressure in elderly persons with renal insufficiency. Elevation in systolic blood pressure is explained partially by the reduction in sodium excretion produced by NSAIDs. Body weight changes vary by age, renal function, and type of NSAID administered.

Original languageEnglish (US)
Pages (from-to)80-88
Number of pages9
JournalAmerican Journal of the Medical Sciences
Issue number2
StatePublished - Aug 1997



  • Aged
  • Blood pressure
  • Elderly
  • Electrolyte excretion

ASJC Scopus subject areas

  • Medicine(all)

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