Nephrotic Syndrome Associated with Use of the Nonsteroidal Anti-Inflammatory Drugs

Feinfeld, Donald A.; Olesnicky, Ludmilla; Pirani, Conrad L.; Appel, Gerald B.

doi:10.1159/000183239

Cited by 52 publications

(25 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some overlap of these effects may be observed in the nontypical patient [6]. The nephrotic syn drome without interstitial nephritis also was reported recently [7], The patient we reported here had interstitial nephritis with nephrotic syndrome (INNS). At least 39 such cases with this type of renal dysfunction have been reported in the past 5 years.…”

Section: Commentsupporting

confidence: 80%

Progression of Minimal-Change Glomerulopathy to Focal Glomerulosclerosis in a Patient with Fenoprofen Nephropathy

et al. 1986

View full text Add to dashboard Cite

We report a patient who presented with the classical features of fenoprofen-induced nephropathy. Initial response to a cessation of the drug and prednisone therapy was recovery of renal function, but proteinuria persisted. One year later, he experienced recurrence of the nephrotic syndrome with sustained renal failure. A clear progression from minimal-change lesions to focal glomerulosclerosis was shown in sequential renal biopsies. Not previously reported, this evolution is suggestive of the possibility that fenoprofen nephropathy may lead to chronic renal failure.

show abstract

Section: Commentsupporting

confidence: 80%

Progression of Minimal-Change Glomerulopathy to Focal Glomerulosclerosis in a Patient with Fenoprofen Nephropathy

et al. 1986

View full text Add to dashboard Cite

show abstract

“…In adults, it becomes important to exclude secondary causes such as malignancy [6] and drugs [3][4][5] when initially evaluating patients with this lesion, as course and therapy can be substantially differ ent as compared to patients with idiopathic disease.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical features which have been reported with respect to this lesion among children include a male preponderance and an association with HLA-DR7 [2]; however, these characteristics do not ap pear to be significant characteristics of the adult popula tion. Additionally, the finding of MCG due to secondary causes, such as drugs [3][4][5] and lymphoproliferative dis orders [6], among the adult population exceeds that seen in children.…”

Section: Introductionmentioning

confidence: 98%

Minimal-Change Glomerulopathy of Adulthood

Korbet¹,

Schwartz²,

Lewis³

1988

Am J Nephrol

View full text Add to dashboard Cite

We describe 40 adults with idiopathic minimal-change glomerulopathy. They consisted of 27 females and 13 males, mean age 40.7 ± (SD) 19.8 years (range 15–78 years). Twenty patients were < 40 years of age at presentation. They presented with significantly ( p < 0.05) lower serum creatinine (0.9 ± 0.2 vs. 1.3 ± 0.5 mg/dl) and serum albumin (1.9 ± 0.8 vs. 2.4 ± 0.7 g/dl) levels than patients > 40 years. Only 7 patients (18%) presented with a decrease in renal function (serum creatinine > 1.3 mg/dl). All patients had nephrotic-range proteinuria at the time of presentation or biopsy. There was no significant difference in presenting proteinuria (8.7 ± 5.7 g/24 h) or length of follow-up (mean 63.5, range 4–176 months) between the two age groups. Microscopic hematuria and hypertension were each present in 21 % of the patients. Thirty-four patients received therapy with prednisone. A complete remission was obtained in 91 % of the patients treated with prednisone. The response occurred within 16 weeks in 77% of the patients. The response to prednisone therapy was similar for patients < 40 years when compared to those > 40 years, with a complete remission being obtained in 88 and 94%, respectively. The rate of response, however, differed significantly with 73% of patients < 40 years versus 32% of patients > 40 years achieving a complete remission by 8 weeks. Twenty patients initially responding to prednisone therapy (64.5%) relapsed. A relapse occurred within 3 months of attaining a complete remission in 70% of the patients. No difference was recognized between patients < 40 or > 40 years with respect to initial relapse time or total relapses. Eight patients (26%) were steroid dependent. A spontaneous complete remission occurred in 2 patients. At last follow-up, 29 patients (72.5%) were in complete remission, 3 patients were in a partial remission (7.5%), and 8 patients (20%) were nephrotic. Our experience shows that adults with minimal-change glomerulopathy have a clinical presentation and course similar to that of children with the same lesion. A major difference was that the rate of response in our patients was slower than that reported in children. Once in remission, relapse rate and prognosis of our adults mirrored that of the childhood experience with minimal-change glomerulopathy.

show abstract

“…A subsequent literature review noted that NSAID-associated MCD may occur in the absence of AIN (23). This report included 24 patients with MCD, among whom 15 patients received fenoprofen.…”

Section: Nonsteroidal Anti-inflammatory Drugsmentioning

confidence: 99%

“…This report included 24 patients with MCD, among whom 15 patients received fenoprofen. Patients presented with full-blown NS and had excellent outcomes after NSAID discontinuation, often in the absence of corticosteroids (23). NSAIDs subsequently have been recognized as a drug-induced etiology of MCD.…”

Section: Nonsteroidal Anti-inflammatory Drugsmentioning

confidence: 99%

Drug-Induced Glomerular Disease

Markowitz¹,

Bomback

Perazella

2015

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

The potential of medications to cause kidney injury is well known. Although nephrotoxicity is most commonly associated with injury in the tubulointerstitial compartment as either acute tubular necrosis or acute interstitial nephritis, a growing body of literature has also highlighted the potential for drug-induced glomerular lesions. This review surveys the three primary patterns of drug-induced glomerular diseases stratified by the cell type at which the glomerular lesion is focused: visceral epithelial cell (or podoctye) injury, endothelial cell injury, and mesangial cell injury. A number of commonly prescribed medications, including IFNs, bisphosphonates, nonsteroidal antiinflammatory drugs, antiplatelet agents, and antiangiogenesis drugs, that are both prescribed and available over the counter, have been implicated in these iatrogenic forms of glomerular disease. Recognition of these druginduced etiologies of glomerular disease and rapid discontinuation of the offending agent are critical to maximizing the likelihood of renal function recovery.

show abstract

Nephrotic Syndrome Associated with Use of the Nonsteroidal Anti-Inflammatory Drugs

Cited by 52 publications

References 9 publications

Progression of Minimal-Change Glomerulopathy to Focal Glomerulosclerosis in a Patient with Fenoprofen Nephropathy

Progression of Minimal-Change Glomerulopathy to Focal Glomerulosclerosis in a Patient with Fenoprofen Nephropathy

Minimal-Change Glomerulopathy of Adulthood

Drug-Induced Glomerular Disease

Contact Info

Product

Resources

About