Common anti-fever medications can cause acute kidney injury in children
27 January, 2013
ISLAMABAD: Researchers have warned that sick children, especially those with some dehydration from flu or other illnesses, risk significant kidney injury if given drugs such as ibuprofen and naproxen.
Jason Misurac and his colleagues from Indiana University School of Medicine and Butler University said that nearly three percent of cases of paediatric acute kidney injury over a decade could be traced directly to having taken the common non-steroidal anti-inflammatory drugs, or NSAIDs.
Although relatively few in terms of percentage of total kidney damage cases, the children with problems associated with NSAIDs included four young patients who needed dialysis, and at least seven who may have suffered permanent kidney damage, the researchers said.
"These cases, including some in which patients' kidney function will need to be monitored for years, as well as the cost of treatment, are quite significant, especially when you consider that alternatives are available and acute kidney injury from NSAIDs is avoidable," Dr. Misurac, a fellow in paediatric nephrology, said.
Although such drugs have been linked to kidney damage in small, anecdotal reports, their study is believed to be the first large-scale study of the incidence and impact of acute kidney injury caused by NSAIDs. The research team evaluated medical records at Riley Hospital for Children at IU Health in Indianapolis from January 1999 through June 2010 and found 1,015 cases in which patients had been treated for acute kidney injury from any cause.
After excluding cases in which the acute kidney injuries could possibly be explained by other factors, such as diseases affecting kidney function, the researchers found 27 cases, or 2.7 percent, in which the only factors were the administration of NSAIDs. In nearly all cases, the NSAIDs were administered before the children were admitted to the hospital.
Because many of the 1,015 cases involved multiple potential causes of acute kidney injury, the researchers said the 27 cases are likely an underestimate of the number of cases in which NSAIDs contributed to the kidney damage. The researchers found that most of the children had been treated with recommended dosages.
All of the children under the age of five needed to undergo dialysis temporarily, were more likely than the older children to be placed in an intensive care unit and needed longer hospital stays.