Clinicopathological characteristics of non-steroid anti-inflammation drug acute kidney injury
Objective To further understand the characteristics of non-steroid anti-inflammatory drugs(NSAIDs) acute kidney injury(AKI).Methods Twenty-seven cases of NSAIDs-induced renal injury diagnosed from Jan 1st,2000 to Dec 31 st 2012 were enrolled,and followed up for more than one year to exclude kidney d...
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| Main Authors: | , |
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| Format: | Article |
| Language: | zho |
| Published: |
Editorial Department of Journal of Clinical Nephrology
2015-01-01
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| Series: | Linchuang shenzangbing zazhi |
| Subjects: | |
| Online Access: | http://www.lcszb.com/thesisDetails?columnId=57920973&Fpath=home&index=0 |
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| Summary: | Objective To further understand the characteristics of non-steroid anti-inflammatory drugs(NSAIDs) acute kidney injury(AKI).Methods Twenty-seven cases of NSAIDs-induced renal injury diagnosed from Jan 1st,2000 to Dec 31 st 2012 were enrolled,and followed up for more than one year to exclude kidney diseases induced by other drugs and origins.Characteristics of pathogenetic drugs,laboratory examinations and clinical presentations of the renal injury were analyzed.Results Acute renal injury to varying degrees was diagnosed in 27 cases.Serum creatinine were 109.8 ~730.1 μmol/L at the time of diagnosis.One patient presented minimal change disease accompanied by tubulointestitial nephritis.The main causative drugs included acetaminophen,aminopyrine,and ibuprofen,accounting for 66.7%,14.8% and 11.1%respectively.The renal injury occurred after 1 to even 60 days of drug exposure.Only 40.8% of patients with acute renal injury could be early diagnosed within 2 weeks.There were 26 cases of tubulointerstitial nephritis.Renal glucoseuria and obvious urinary α1-microglobulin could be observed.The average urinary protein was(1.1 ± 0.6)g/d.Fourteen cases were confirmed pathologically afterwards.One female patient presenting nephrotic syndrome had both minimal change disease and tubulointerstitial nephritis.All patients were given prednisone(25-40 mg/d) for a total of 3-6 months,and 18.5% of them were given prednisone in combination with immunosuppressants.During a follow-up period of one year,ten(37.0%) patients remained CKD 3-4.One patient with hepatitis B died because of severe hepatopathy.Conclusions All the NSAIDs administrated before AKI should be suspected as the causative agents,and be avoided afterwards.Among them,acetaminophen was the most frequent Tubulointerstitial nephritis was the main clinical-pathological finding,with or without minimal changes of glomerulus.Urinalysis and renal function need to be closely monitored.Timely drug withdrawal combined with prednisone was recommended on the basis of an early diagnosis. |
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| ISSN: | 1671-2390 |