Non-COX-2 NSAIDs can increase BP and cause kidney injury. Which factor would increase NSAID-related kidney injury risk?

• A. Age
• B. Dehydration
• C. All of the above
• D. None of the above

Answer: (C)

Nonselective NSAIDs raise kidney injury risk by blocking prostaglandin synthesis, which normally helps dilate the kidney’s blood vessels and maintain adequate GFR when perfusion is challenged. Aging kidneys have reduced reserve and less robust autoregulation, so they’re less able to compensate for the drop in renal blood flow caused by NSAIDs. Dehydration lowers circulating volume, increasing the kidney’s dependence on prostaglandin-mediated dilation to preserve GFR; when NSAIDs block that mechanism, the risk of prerenal AKI rises. Because both older age and dehydration independently raise this risk, together they amplify it, making all-of-the-above the best choice.