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5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat
Published on: July 3, 2013
Acute renal failure due to sulfinpyrazone
1Department of Medicine, Vanderbilt University Medical Center and Veterans Affairs Medical Center, Nashville, Tennessee 37232-2372, USA.
The American Journal of the Medical Sciences
|May 20, 1998
Summary
Sulfinpyrazone can cause acute tubular necrosis and reversible acute kidney injury, particularly in patients with volume depletion. Diagnosis involves urine microscopy and fractional excretion of sodium, with treatment focused on hydration and drug withdrawal.
Area of Science:
- Nephrology
- Clinical Pharmacology
Background:
- Sulfinpyrazone is a uricosuric agent used in treating gout.
- Acute renal failure is a potential adverse effect of sulfinpyrazone therapy.
Observation:
- A case report details sulfinpyrazone-associated acute renal failure.
- The condition manifested as acute tubular necrosis.
- Patients with volume depletion are particularly susceptible.
Findings:
- Brown tubular casts in urine microscopy and fractional excretion of sodium > 1 are diagnostic indicators.
- Differential diagnoses include uric acid nephropathy and allergic interstitial nephritis.
- Potential mechanisms involve inhibition of renal prostaglandin synthesis and kallikrein activity, leading to reduced renal blood flow.
Implications:
- Prompt diagnosis and management, including intravascular hydration and sulfinpyrazone discontinuation, are crucial for recovery.
- Identifying patients with intravascular volume depletion is key for risk stratification and prevention of sulfinpyrazone-induced acute kidney injury.
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