The use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen, may cause a usually mild renal insufficiency, possibly related to a mild interstitial nephritis or glomerulonephritis. Risk of NSAID-induced renal damage is increased in the elderly and in patients with underlying renal disease. Glipizide a second-generation sulfonylurea, may predispose patients to hypoglycemia but is not associated with renal toxicity. Metformin does not induce renal damage but should be used cautiously in patients with underlying renal damage because of the possibility of developing lactic acidosis.  Neither nifedipine nor propranolol has a tendency to adversely affect the kidneys.