Acute nonoliguric renal failure in children associated with nonsteroidal antiinflammatory agents

Schaller, Susanne; Kaplan, Bernard S.

doi:10.1097/00006565-199812000-00011

Cited by 41 publications

(18 citation statements)

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“…33 Notably, the SCD population already experiences high rates of kidney complications, some chronic and sometimes requiring transplantation, [34][35][36][37][38][39][40][41][42][43] and NSAIDs have been associated with acute renal failure in patients with SCD. 44,45 To resolve these lingering questions and the efficacy and safety of NSAIDs in adult VOC requiring hospitalization, we undertook a prospective, double-blind, randomized, controlled trial in which we For personal use only. on April 28, 2019. by guest www.bloodjournal.org From compared ketoprofen to placebo for adults with SCD and severe VOC requiring hospitalization.…”

Section: Introductionmentioning

confidence: 99%

A randomized, controlled clinical trial of ketoprofen for sickle-cell disease vaso-occlusive crises in adults

Bartolucci¹,

Murr²,

Roudot‐Thoraval

et al. 2009

Blood

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Vaso-occlusive crisis (VOC) is the primary cause of hospitalization of patients with sickle-cell disease. Treatment mainly consists of intravenous morphine, which has many dose-related side effects. Nonsteroidal antiinflammatory drugs have been proposed to provide pain relief and decrease the need for opioids. Nevertheless, only a few underpowered trials of nonsteroidal antiinflammatory drugs for sickle-cell VOC have been conducted, and conflicting results were reported. We conducted a phase 3, double-blind, randomized, placebo-controlled trial with ketoprofen (300 mg/day for 5 days), a nonselective cyclooxygenase inhibitor, for severe VOC in adults. A total of 66 VOC episodes were included. The primary efficacy outcome was VOC duration. The secondary end points were morphine consumption, pain relief, and treatment failure. Seven VOC episodes in each group were excluded from the analysis because of treatment failures. No significant between-group differences were observed for the primary outcome or the secondary end points. Thus, although ketoprofen was well-tolerated, it had no significant efficacy as treatment of VOC requiring hospitalization. These findings argue against its systematic use in this setting. IntroductionPain is the most frequent manifestation of sickle-cell disease (SCD) and is thought to be a consequence of sickle-cell vaso-occlusion. Vaso-occlusive crisis (VOC) is the primary cause of hospitalization of patients with SCD and is among the main causes of death in affected adults. 1,2 To date, no specific therapeutic agents have been approved for VOC, and treatment of uncomplicated VOC is merely symptomatic: bed rest, analgesics and hydration. According to American and British recommendations,3,4 severe pain of VOC that requires hospitalization should be treated with intravenous morphine. However, pain relief is not easily obtained during episodes of VOC, and morphine has many dose-related side effects, including sedation, nausea, constipation, pruritus, and hypoventilation. In addition, it might contribute to the development of acute chest syndrome. 5 In light of these potentially severe adverse events, many physicians are still reluctant to administer high doses of potent narcotics, and many medical texts do not provide adequate information for the treatment of pain. 6 A drug that would provide pain relief in patients with SCD and decrease the need for narcotics would be of obvious benefit.According to the results of 2 trials, 7,8 corticosteroids had a potentially beneficial effect on VOC by reducing the duration of analgesics, but corticosteroids have been shown to induce recurrent pain episodes. 7-11 Pilot trials with inhaled nitric oxide 12 and poloxamer 188 13 yielded promising results but were experimental, and those treatments are not yet available for routine use.Nonsteroidal antiinflammatory drugs (NSAIDs) are an effective treatment to decrease surgical and posttraumatic pain. 14-21 NSAIDs and opioid analgesics have a synergic effect, 22 thereby achieving better pain control and an ...

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Section: Introductionmentioning

confidence: 99%

A randomized, controlled clinical trial of ketoprofen for sickle-cell disease vaso-occlusive crises in adults

Bartolucci¹,

Murr²,

Roudot‐Thoraval

et al. 2009

Blood

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“…Acute tubulointerstitial nephritis is an uncommon cause of acute renal failure (ARF) in children [1]. Researchers have suggested that it maybe under-recognized.…”

Section: Introductionmentioning

confidence: 99%

“…Researchers have suggested that it maybe under-recognized. Patients usually present with non-specific symptoms and signs, so that the diagnosis of ATIN is often delayed [1,2]. The disease may be infection-or drug-induced, or it may occur without a known cause [3].…”

Section: Introductionmentioning

confidence: 99%

“…Medications commonly associated with acute tubulointerstitial nephritis include antibiotics such as penicillin, ampicillin, methicillin, and non-antibiotics like furosemide, thiazide diuretics, and non-steroidal anti-inflammatory drugs (NSAIDs) [1][2][3]. NSAIDs not only induce acute tubulo-interstitial nephritis and acute renal failure, but they also cause minimal change disease and, rarely, membranous glomerulopathy and papillary necrosis [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…NSAIDs not only induce acute tubulo-interstitial nephritis and acute renal failure, but they also cause minimal change disease and, rarely, membranous glomerulopathy and papillary necrosis [1,2].…”

Section: Introductionmentioning

confidence: 99%

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Non-steroidal anti-inflammatory drugs-associated acute interstitial nephritis with granular tubular basement membrane deposits

Dixit¹,

Nguyen

Carson³

et al. 2008

Pediatr Nephrol

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Acute tubulo-interstitial nephritis (ATIN) is an important cause of acute renal failure resulting from a variety of insults, including immune complex-mediated tubulo-interstitial injury, but drugs such as non-steroidal anti-inflammatory drugs (NSAIDs) are a far more frequent cause. Overall, as an entity, ATIN remains under-diagnosed, as symptoms resolve spontaneously if the medication is stopped. We report on a 14-year-old boy who developed acute renal failure 2 weeks after aortic valve surgery. He was put on aspirin following surgery and took ibuprofen for fever for nearly a week prior to presentation. He then presented to the emergency department feeling quite ill and was found to have a blood urea nitrogen (BUN) concentration of of 147 mg/dl, creatinine of 15.3 mg/dl and serum potassium of 8.7 mEq/l. Dialysis was immediately initiated. A kidney biopsy showed inflammatory infiltrate consistent with ATIN. However, in the tubular basement membrane (TBM), very intense granular deposits of polyclonal IgG and C3 were noted. He needed dialysis for 2 weeks and was treated successfully with steroids for 6 months. His renal recovery and disappearance of proteinuria took a year. In conclusion, this is a first report of NSAIDs-associated ATIN, showing deposits of granular immune complex present only in the TBM and not in the glomeruli.

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Diclofenac for acute pain in children

Standing

Savage

Pritchard

et al. 2009

Cochrane Database of Systematic Reviews

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Acute nonoliguric renal failure in children associated with nonsteroidal antiinflammatory agents

Cited by 41 publications

References 0 publications

A randomized, controlled clinical trial of ketoprofen for sickle-cell disease vaso-occlusive crises in adults

A randomized, controlled clinical trial of ketoprofen for sickle-cell disease vaso-occlusive crises in adults

Non-steroidal anti-inflammatory drugs-associated acute interstitial nephritis with granular tubular basement membrane deposits

Diclofenac for acute pain in children

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