Effect of non-steroidal anti-inflammatory drugs (diclofenac, celecoxib, nimesulide, diacerein) on renal transport of uric acid in patients with oxalate nephropathy and concomitant gonarthritis

The aim of the study is to evaluate the excreted uric acid fraction in patients with oxalate nephropathy in the early stages of chronic kidney disease with gonarthritis under non-steroidal anti-inflammatory drug therapy. Materials and Methods. An open, comparative, randomized study included 192 women, aged 51.4±2.3, with oxalate nephropathy and primary gonarthritis. The glomerular filtration rate was >60 ml/min, BMI 23.4±1.8. The first group of patients was taking Diclofenac Sodium (4500 mg/month), the second group Celecoxib (6000 mg/month), the third group Nimesulide (6000 mg/month), the fourth group -Diacerein (6000 mg/2 months). The control group for each drug consisted of patients with gonarthritis, but without nephropathy and hyperuricemia. The patients of the control groups were treated similarly. The excreted fraction of uric acid in the subjects was assessed on Day 15, Day 30, and Day 60 according to generally accepted methods. Results. A decrease in the excreted fraction of uric acid, hyperuricemia, and a decrease in the glomerular filtration rate were observed in patients taking Diclofenac. After one-month Diclofenac withdrawl, the parameters did not return to their original levels. Celecoxib and Nimesulide had margical effect on the changes of the excreted uric acid fraction and a decrease in glomerular filtration rate. A month after their withdrawl, the parameters returned to their original levels. Diacerein had no effect on the renal transport of uric acid. No significant changes were noted in the control.