Piroxicam-induced renal disease.

Two cases of nephrotoxicity associated with piroxicam therapy are reported. In the first case, severe reversible azotemia with hyperkalemia resolved after discontinuation of the medication. In the second case, biopsy-proved acute interstitial nephritis with immune complex glomerulonephritis and hepatitis improved after steroid therapy. The mechanism for such toxicity may be altered hemodynamics, cellular immunity, or humoral immunity related to prostaglandin inhibition.