ABSTRACT
Non-steroidal anti-inflammatory drugs (NSAIDs) inhibit the synthesis of renal prostaglandins that would normally dilate the afferent arterioles. In the presence of low renal blood flow, NSAIDs may cause acute renal failure (ARF). These drugs are contraindicated in patients with impending renal failure. Angiotensin-converting enzyme (ACE) inhibitors are also contraindicated in these patients; they reduce the production of angiotensin-2 that normally constricts the efferent arterioles, thus maintaining glomerular perfusion pressure.
