Efficacy of COX-2 Inhibitors in a Case of Congenital Nephrogenic Diabetes Insipidus
| Title: | Efficacy of COX-2 Inhibitors in a Case of Congenital Nephrogenic Diabetes Insipidus |
|---|---|
| Authors: | Soylu, Alper; Kasap, Belde; Ogun, Nilufer; Ozturk, Yesim; Turkmen, Mehmet; Hoefsloot, Lies H.; Kavukcu, Salih |
| Publisher: | FEBS Letters |
| Date Published: | December 01, 2005 |
| Reference Number: | 699 |
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This translation by the NDI Foundation is to assist the lay reader. To provide a clear, accessible interpretation of the original article, we eliminated or simplified some technical detail and complicated scientific language. We concentrated our translation on those aspects of the article dealing directly with NDI. The NDI Foundation thanks the researchers for their work toward understanding and more effectively treating this disorder.
© Copyright NDI Foundation 2007 (JC)
Soylu, et al., had, as their patient, a 17 month old boy with congenital nephrogenic diabetes insipidus. He had been diagnosed at the age of one and had been placed on a treatment regime comprised of a combination of the drugs, amiloride and hydrochlorothiazide. Though this combination has proved somewhat effective mitigating the excessive urination and thirst associated with NDI, it was not proving effective for the patient. The medical team added a third drug, rofecoxib, to the first two and placed the boy on a low sodium diet. This resulted in a dramatic reduction in the boy’s symptoms.
Rofecoxib is a selective cyclooxygenase-2 (COX-2) inhibitor. COX -2 inhibitors reduce urinary sodium excretion by reducing blood flow through the inner portion of the kidney or reducing the flow rate through the kidney’s glomular filtration system. Despite the dramatic results, the medical team stopped administering rofecoxib because of the possibility of side effects. They substituted first indomethacin, then ibuprofen, but neither resulted in the same efficacy as did their first combination. Then the team tried adding another selective COX-2 inhibitor, celecoxib, to the amiloride and hydrochlorothiazide. This, in conjunction with the low sodium diet, produced a greater reduction of the boy’s NDI symptoms, closer to the reduction achieved with their first combination.
Soylu, et al., conclude that the combination of hydrochlorothiazide/amiloride/COX-2 inhibitor could be successfully used to treat cNDI, and that they had noticed no side effects from either of the COX-2 inhibitors they used on their patient.