The effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on postoperative renal function: A meta-analysis

A. Lee, M. G. Cooper, J. C. Craig, J. F. Knight, J. P. Keneally

Research output: Contribution to journalReview articlepeer-review

41 Citations (Scopus)


The aim of this systematic review was to assess the effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on post-operative renal function. Eight randomized placebo-controlled double-blinded trials (n = 345) were identified from searches of MEDLINE, EMBASE and the Cochrane Controlled Trials Register databases. The summary effect size and 95% confidence intervals (95% CI) were calculated by a weighted mean difference analysis using a random-effects model. The NSAIDs (diclofenac, ketorolac, indomethacin, ibuprofen) were used for up to three-days after surgery. There were no reported cases of postoperative renal failure requiring dialysis. NSAIDs reduced creatinine clearance by 22 ml.min-1 (95% CI: 7 to 37), sodium output by 54 (95% CI: 5 to 103) and potassium output by 38 (95% CI: 19 to 56) on Day 1 but not on Day 2. Serum creatinine increased on Day 2 by 15 mumol.l-1 (95% CI: 2 to 28). Urine volume did not change significantly at any time. There was therefore a clinically unimportant transient reduction in renal function. NSAIDs should not be withheld from patients with normal preoperative renal function because of concerns about postoperative renal impairment.
Original languageEnglish
Pages (from-to)574-580
Number of pages7
JournalAnaesthesia and Intensive Care
Issue number6
Publication statusPublished - Dec 1999
Externally publishedYes


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