RT Book, Section
A1 Perazella, Mark A.
A2 Lerma, Edgar V.
A2 Berns, Jeffrey S.
A2 Nissenson, Allen R.
SR Print(0)
ID 6333893
T1 Chapter 15. NSAIDs & the Kidney: Acute Renal Failure
T2 CURRENT Diagnosis & Treatment: Nephrology & Hypertension
YR 2009
FD 2009
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-144787-4
LK accessmedicine.mhmedical.com/content.aspx?aid=6333893
RD 2024/04/23
AB Nonsteroidal  anti-inflammatory  drug  (NSAID)-associated  acute  renal  failure  (ARF)  develops  predominantly  in  patients  with  underlying  risk  factors.Clinical  presentations  can  be  asymptomatic  or  associated  with  uremic  symptoms,  edema  (pulmonary  and  peripheral),  hypertension,  or  electrolyte  and  acid–base  disturbances.Elevated  blood  urea  nitrogen  (BUN)  and  serum  creatinine  (Cr)  concentrations  are  present.An  elevated  BUN/Cr  ratio  (>  20)  is  often  noted.Hyponatremia  (serum  [Na+]    5.5  mEq/L),  and  non-anion  gap  metabolic  acidosis  (serum  [HCO3−]  <  20  mEq/L)  are  common.Urine  [Na+]  <  10–20  mEq/L  and  FeNa+  <  1.0%  characterize  NSAID-associated  ARF.ARF  is  generally  reversible  with  discontinuation  of  NSAIDs  and  treatment  of  concurrent  disease  processes.Severe  ARF  from  NSAIDs  may  require  dialysis.