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Nabumetone-associated interstitial nephritis
E Blackwell1, K Loughlin, F Dumler
1St. John Hospital and Medical Center, Detroit, Michigan, USA.
Pharmacotherapy
|September 1, 1995
Summary
Nonsteroidal anti-inflammatory drug (NSAID) nephropathy can cause severe kidney damage, including nephrotic syndrome and acute kidney injury. Early recognition and management are crucial for patient outcomes.
Area of Science:
- Nephrology
- Pharmacology
Background:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for pain and inflammation.
- NSAID-induced nephropathy is a known but often underdiagnosed complication.
Observation:
- An 84-year-old woman presented with edema and decreased urine output after 6 months of nabumetone use.
- She exhibited significant edema, electrolyte abnormalities, and severe proteinuria (3061 mg/dl).
- Laboratory findings revealed acute kidney injury with elevated creatinine (2.7 mg/dl) and BUN (70 mg/dl).
Findings:
- Renal biopsy confirmed tubular damage consistent with NSAID-induced nephropathy.
- Despite diuresis and hemodialysis, the patient developed persistent nephrotic syndrome (13 g protein/day).
- The patient experienced infectious complications and ultimately died.
Implications:
- This case highlights the potential for severe renal toxicity from NSAIDs, even with short-term use.
- NSAID-induced nephropathy can lead to irreversible kidney damage and nephrotic syndrome.
- Clinicians should maintain a high index of suspicion for NSAID-induced nephropathy in patients with unexplained kidney injury.