Do Non-Steroidal Anti-Inflammatory Drugs Cause Kidney Failure in Children?
Dr. Jason Misurac and colleagues from the Indiana University School of Medicine and Butler University retrospectively screened all patients hospitalized at Riley Hospital for Children at IU Health who were identified with AKI. Out of 1015 patients with AKI, 27 were identified to have NSAID-associated AKI. Seventy-eight percent of the 27 patients had been using NSAIDs for less than 7 days, and 75% took the medication at the correct dosage. In 67% of the cases, the family reported that the child had signs of dehydration. Most of the patients were teens; however, patients who were less than 5 years old were more seriously affected and more likely to need dialysis. Although the reasons for younger children having a more severe disease course are unknown, the authors speculate that it could be due to an increased susceptibility to the toxic effects of NSAIDs. None of the patients died or developed permanent kidney failure, but 30% of the children had evidence of mild chronic kidney damage persisting after recovery from the episode of AKI.
The costs of caring for children with NSAID-associated AKI are significant, especially considering that this is an avoidable condition. Adding to this cost burden is the long-term care needed, because studies show that these patients have an increased risk of progressive chronic kidney disease. In some cases, acetaminophen might be a more appropriate choice for treatment. “This study underscores the importance of understanding the natural history of NSAID-associated AKI, including the potential for development of chronic kidney disease,” notes Dr. Misurac. “Providers should continue to provide careful NSAID education to parents and children.”
Notes for editors
"Non-steroidal Anti-inflammatory Drugs Are an Important Cause of Acute Kidney Injury in Children,” by Jason M. Misurac, MD, Chad A. Knoderer, PharmD, Jeffrey D. Leiser, MD, PhD, Corina Nailescu, MD, Amy C. Wilson, MD, and Sharon P. Andreoli, MD, appears in The Journal of Pediatrics(www.jpeds.com), DOI 10.1016/j.jpeds.2012.11.069, published by Elsevier
About The Journal of Pediatrics
The Journal of Pediatrics is a primary reference for the science and practice of pediatrics and its subspecialties. This authoritative resource of original, peer-reviewed articles oriented toward clinical practice helps physicians stay abreast of the latest and ever-changing developments in pediatric medicine. The Journal of Pediatrics is ranked 4th out of 113 pediatric medical journals (2011 Journal Citation Reports®, published by Thomson Reuters). URL: www.jpeds.com
Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Research Intelligence and ClinicalKey— and publishes over 2,500 journals, including The Lancet and Cell, and more than 35,000 book titles, including a number of iconic reference works. Elsevier is part of RELX Group, a world-leading provider of information and analytics for professional and business customers across industries. www.elsevier.com