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May 1992

Acute Renal Failure and Glomerulopathy Caused by Nonsteroidal Anti-inflammatory Drugs

Author Affiliations

From the Department of Medicine, University of Nevada School of Medicine (Dr S. Shankel), Washoe Medical Center (Drs Johnson, Clark, and O'Neil), Reno, Nev; and Department of Medicine, Loma Linda (Calif) University School of Medicine (Drs S. Shankel and T. Shankel).

Arch Intern Med. 1992;152(5):986-990. doi:10.1001/archinte.1992.00400170074014

Nonsteroidal anti-inflammatory drugs are now one of the most common causes of acute renal failure (ARF). To define more clearly the magnitude of the problem, we reviewed all cases of ARF in the Reno (Nev) area from 1972 through 1986. Twenty-seven cases of ARF and seven cases of glomerulopathy were identified, primarily during the last 5 years of the study period. Twenty-three of the cases of ARF and six of the cases of glomerulopathy cleared an average of 23 and 118 days, respectively, after treatment with the nonsteroidal anti-inflammatory drug was stopped. Two cases of ARF persisted, and two patients died. Proteinuria, hematuria, and casts were prominent in both ARF and glomerulopathy but were more pronounced in the glomerulopathies. The treatment of choice is to stop the use of the nonsteroidal anti-inflammatory drug. The role of steroids has not been evaluated.

(Arch Intern Med. 1992;152:986-990)