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Single-dose diclofenac in healthy volunteers can cause decrease in renal perfusion measured by functional magnetic

Susanne Hellms1, Faikah Gueler2, Marcel Gutberlet1

  • 1Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.

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Summary

Single-dose diclofenac significantly reduced kidney blood flow in healthy volunteers with high drug levels. This finding highlights potential risks for individuals with pre-existing kidney conditions.

Keywords:
arterial spin labellingdiclofenacfunctional magnetic resonance imagingnon-steroidal anti-inflammatory drugrenal perfusion

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Area of Science:

  • Nephrology
  • Pharmacology
  • Radiology

Background:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like diclofenac are widely used.
  • NSAIDs can affect kidney function, but the impact of different administration routes is not fully understood.

Purpose of the Study:

  • To investigate the effects of oral and topical diclofenac on renal perfusion in healthy individuals.
  • To correlate diclofenac plasma concentrations with changes in kidney blood flow using functional MRI.

Main Methods:

  • Functional magnetic resonance imaging (fMRI) with arterial spin labelling (ASL) was used to measure renal perfusion.
  • 24 healthy volunteers received a single oral dose of diclofenac (50 mg); 12 also received topical diclofenac for 3 days.
  • Plasma diclofenac levels and serum thromboxane concentrations were measured.

Main Results:

  • Oral diclofenac led to wide inter-individual variations in plasma concentrations.
  • Topical diclofenac resulted in negligible systemic levels.
  • A significant reduction in renal perfusion was observed in participants with diclofenac levels ≥225 nm (P < 0.01).
  • Diclofenac levels correlated negatively with thromboxane B2 levels, indicating drug target engagement.

Conclusions:

  • Even a single oral dose of diclofenac can decrease renal perfusion in individuals reaching sufficient plasma concentrations.
  • These findings suggest potential renal risks associated with diclofenac, particularly in vulnerable patient populations with kidney disease.