プレドニゾンのようなコルチコステロイドもプロスタグランジン合成に影響を与えるため、 NSAIDと比較してコルチコステロイドが比較的fewer kidney-related side-effectsあるのはなぜですか？
Corticosteroids block the enzyme Phospholipase A2 (PLA2) which catalyses the first step in arachidonic acid synthesis pathway. But, NSAIDs blocks activity of cyclooxygenases (COX 1 and COX 2).
So, by blocking this pathway at first step completely prevents the formation of of Arachidonic acid, but when this pathway is blocked later at step performed by COX enzyme, other inflammatory pathways are still active which are performed by Lipoxygenases (LOX). LOX enzyme is involved in synthesizes of leukotrienes which are responsible for inducing inflammatory damage to kidneys.