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Published on: May 6, 2018
Mefenamic acid nephropathy: an interstitial and mesangial lesion
D A Jenkins1, D J Harrison, M K MacDonald
1Medical Renal Unit, Royal Infirmary of Edinburgh, UK.
Summary
Mefenamic acid can cause acute kidney injury, often presenting with gastrointestinal symptoms and salt depletion. Renal biopsies reveal interstitial nephritis and mesangial changes, with most patients recovering after drug withdrawal.
Area of Science:
- Nephrology
- Pharmacology
- Internal Medicine
Background:
- Mefenamic acid is a nonsteroidal anti-inflammatory drug (NSAID).
- NSAIDs are known to cause renal adverse effects.
- Acute kidney injury (AKI) is a potential complication of NSAID use.
Purpose of the Study:
- To describe cases of acute renal failure associated with mefenamic acid.
- To identify clinical and pathological features of mefenamic acid-induced AKI.
- To understand the renal outcomes following mefenamic acid withdrawal.
Main Methods:
- Case series describing six patients with acute renal failure.
- Clinical assessment including symptoms and fluid balance.
- Renal biopsy analysis in five patients.
- Follow-up to assess renal recovery.
Main Results:
- Six cases of acute renal failure linked to mefenamic acid therapy.
- Common symptoms included abdominal pain, diarrhea, and vomiting.
- Renal biopsies showed interstitial nephritis and mesangial proliferation.
- Most patients recovered after discontinuing mefenamic acid, but some had persistent renal impairment.
Conclusions:
- Mefenamic acid can induce acute renal failure.
- Interstitial nephritis and mesangial changes are characteristic pathological findings.
- Early recognition and drug withdrawal are crucial for renal recovery.
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