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Analjezik Alımı Sonrası Akut Tübülointerstisyal Nefrit: Dört Olgu Sunumu

Acute Tubulointerstitial Nephritis: Presentation of Four Cases

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DOI: 
DOI 10.5262/tndt.2013.1001.16
Abstract (2. Language): 
Nonsteroidal anti-inflammatory drugs and paracetamol (acetaminophen) which are analgesic-antipyretic drugs are thought to be safe and are most commonly used in children to control pain and fever. We retrospectively analysed the clinical and laboratory characteristics of four patients who were admitted between 2009-2011 and diagnosed as acute renal failure with a history of analgesic-antipyretic drugs usage. Two of them used flurbiprofen and the other two paracetamol. None of them had any chronic disease. The time between medication and admission to hospital was 3-20 days. Renal biopsy was performed in all patients showing tubulointerstitial inflammation. One patient was given corticosteroid therapy and the other three were treated with hydration only. Renal function tests became normal in 4-9 days. Two of three patients who had proteinuria at admission had normal urinalysis at discharge.
Abstract (Original Language): 
Analjezik-antipiretik ilaçlardan nonsteroid antiinflamatuvar ilaçlar ve parasetamol (asetaminofen), günlük pratikte güvenli olduğu düşünülen, özellikle çocuklarda ağrı ve ateş kontrolünde sık kullanılan ilaçlardır. 2009-2011 yılları arasında akut böbrek yetmezliği saptanan ve analjezik-antipiretik ilaç kullanım öyküsü olan dört hastanın özellikleri incelendi. Hastalardan ikisi flurbiprofen diğer ikisi parasetamol kullanmıştı. Dört olgunun daha önce bilinen bir hastalığı ve başka ilaç kullanım öyküsü yoktu. Analjezik kullanımı ile hastaneye başvuru arasında geçen süre 3-20 gün arasında idi. Tüm olgulara böbrek biyopsisi yapıldı ve histopatolojik olarak interstisyal inflamasyon gösterildi. Üç olgu intravenöz hidrasyon ile, bir hasta ise steroid ile tedavi edildi. Tedavi ile böbrek fonksiyonları 4-9 gün içinde normale döndü. Proteinürisi olan üç hastanın ikisinde proteinüri düzeldi. Analjezik-antipiretik ilaçlara sekonder akut böbrek yetmezliği ve tübülointerstisyal nefrit gelişimi kısa süreli kullanımlarda da görülebilir; bu yüzden hastaların oral sıvı alımları sorgulanmalı ve böbrek fonksiyonları yakın takip edilmelidir.
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REFERENCES

References: 

1. Whelton A, Hamilton CW: Non-steroidal anti-inflammatory drugs:
Effects on kidney function. J Clin Pharmacol 1991; 31:588–598
2. John CM, Shukla R, Jones CA: Using NSAID in volume depleted
children can precipitate acute renal failure. Arch Dis Child 2007;
92: 524–526
3. Onay OS, Erçoban HS, Bayrakçı US, Melek E, Cengiz N, Baskin E:
Acute, reversible nonoliguric renal failure in two children associated
with analgesic –antipyretic drugs. Pediatric Emergency Care 2009;
25 (4): 263-266
4. Banal F, Lecoules S, Carmoi T, Thomas L, Bonnefoy S, Bechade D,
Desrame J, Algayres JP: Acute renal insufficiency after flurbiprofen
treatment in a patient treated with angiotensin converting enzyme
inhibitor. Rev Med Interne 2008; 29 (7): 593-595
5. Tazoe N, Ikezaki N, Ito J, Kuwahara K, Hara M, Nakayama M, Sato
T: A case of acute interstitial nephritis induced by flurbiprofen. Jpn
J Med 1987: 26(2): 230-233
6. Demontis R, Coevoet B, Guellal A, Fournier A: Acute renal
insufficiency caused by observed a combination of enalapril,
furosemide and flurbiprofen in a patient with retroperitoneal
fibrosis. Ann Urol 1987; 21(5): 346-349
7. Schwartz GJ, Muñoz A, Schneider MF, Mak RH, Kaskel F, Warady
BA, Furth SL: New equations to estimate GFR in children with
CKD. J Am Soc Nephrol 2009; 20 (3): 629-637
8. Krause I, Cleper R, Einstein B, Davidovitis M : Acute renal failure,
associated with non-steroidal anti-inflamatory drugs in healthy
children. Pediatr Neprol 2005; 20: 1295-1298
9. Batlouni M: Nonsteroidal antiinflammatory drugs: Cardiovascular,
cerebrovascular and renal effects. Arq Bras Cardiol 2010; 94 (4):
556-563
10. Whelton A: Nephrotoxicity of nonsteroidal antiinflammatory drugs:
physiologic foundations and clinical implications. Am J Med 1999;
106 (5): 13-24
11. Davies NM: Clinical pharmacokinetics of flurbiprofen and its
enantiomers. Clin Pharmacokinet 1995; 28 (2): 100-114
12. Fruchter LL, Alexopoulou I, Lau KK: Acute interstitial nephritis
with acetaminophen and alcohol intoxication. Ital J Pediatr 2011,
37: 17
13. O’Riordan A, Brummell Z, Sizer E, Auzinger G, Heaton N, O’Grady
JG, Bernal W, Hendry BM, Wendon JA: Acute kidney injury in
patients admitted to a liver intensive therapy unit with paracetamol
–induced hepatotoxicity. Nephrol Dial Transplant 2011; 26: 3501-
3508
14. Handa SP: Drug-induced acute interstitial nephritis: Report of 10
cases. CMAJ 1986; 135: 1278-1281
15. Councilman WT: Acute interstitial nephritis. J Exp Med 1898; 3
(4-5): 393-420
16. Dhillon S, Higgins RM: Interstitial nephritis. Postgrad Med 1997;
73: 151-155
17. Blakely P, McDonald BR: Acute Renal Failure due to
Acetaminophen Ingestion: A case report and review of the
literature. J Am Soc Nephrol 1995; 6 (1): 48-53
18. Oymak O: Akut interstisyel nefrit. Turk Neph Dial Transpl 2006; 15
(1): 38-42
19. Kodner CM, Kudrimoti A: Diagnosis and management of acute
interstitial nephritis. Am Fam Physician 2003; 67 (12): 2527-2534
20. Praga M, Gonzales E: Acute interstitial Nephritis. Kidney Int 2010;
77 (11): 956-961

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