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Renal autoregulation with NSAIDs — FRCA Primary MCQ

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HardPhysiologyRenal autoregulation with NSAIDsFRCA Primary

A dehydrated patient receives an NSAID and then develops oliguria after major surgery. Blood pressure is borderline and creatinine rises. Which renal vascular effect best explains this?

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Correct answer: C — Afferent arteriolar constriction from prostaglandin inhibition

Renal prostaglandins help maintain afferent arteriolar vasodilatation during hypovolaemia; NSAIDs remove this support and reduce glomerular filtration. Angiotensin II tends to constrict the efferent arteriole, helping preserve filtration pressure. ADH and aldosterone mainly affect water and sodium handling rather than this acute afferent vascular issue. NSAID renal risk rises sharply when renal perfusion is already threatened.

Reference: Ganong Review of Medical Physiology; Peck, Hill & Williams Pharmacology