Diclofenac induced renal dysfunction presenting as cardiac arrhythmia

A fifty year old male presented on the sixteenth post-operative day after leg surgery with abdominal pain and distension, difficulty to breathe and oliguria. He had bradycardia and hypotension. Electrocardiography (ECG) revealed junctional rhythm and there was biochemical evidence of hyperkalemia. This was attributed to non-steroidal anti inflammatory drug diclofenac sodium induced renal dysfunction.