Authors: Tim Ulinski Vincent Guigonis Olivier Dunan Albert Bensman
Publish Date: 2004/01/24
Volume: 163, Issue: 3, Pages: 148-150
Abstract
Nonsteroidal antiinflammatory drugs NSAIDs are known to have adverse effects on kidney function Situations with a stimulated reninangiotensin system such as volume depletion or preexisting chronic renal failure predispose to acute renal failure ARF via inhibition of prostaglandin synthesis by NSAIDs To date NSAIDs are frequently used as antipyretic drugs even in situations predisposing to ARF Within 20 months seven children presenting with diarrhoea and/or vomiting and fever were treated with therapeutic doses 115–32 mg/kg per day of ibuprofen for 1 to 3 days before developing ARF Maximum plasma creatinine levels were 180–650 µmol/l One patient required emergency dialysis for hyperkalaemia uraemia and hyperphosphataemia After cessation of NSAID treatment and rehydration all patients recovered completely with a normalised creatinine level after 3 to 9 days Once the acute phase is controlled longterm outcome is excellent Interstitial nephritis another possible adverse effect of NSAIDs might require steroid treatment and is the major differential diagnosis Only histological examination can confirm the exact pathomechanism of ARF after NSAID exposure If immunological events are responsible for the ARF the recovery period is usually longer Conclusion nonsteroidal antiinflammatory drugs are potentially dangerous in situations with even moderate volume depletion
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