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Even Correctly Administered NSAIDs Can Cause Acute Kidney Injury in Kids

Pain Management   |   Nephrology   |   Pediatrics   |   Primary Care   |   Hospital Medicine   |  
 
TUESDAY, Jan. 29 (HealthDay News) -- Nonsteroidal anti-inflammatory drug (NSAID)-associated acute kidney injury (AKI) accounts for almost 3 percent of pediatric AKI, according to a study published online Jan. 28 in The Journal of Pediatrics.

Jason M. Misurac, M.D., from Indiana University in Indianapolis, and colleagues retrospectively reviewed the charts of 1,015 children with a diagnosis of AKI to characterize NSAID-linked AKI. A diagnosis explaining AKI or comorbid clinical conditions predisposing to AKI development negated a classification of NSAID-associated AKI.

The researchers found that 21 children had clinical, laboratory, and radiographic studies suggesting NSAID-associated acute tubular necrosis and six had findings suggesting NSAID-associated acute interstitial nephritis, representing 2.7 percent of the total cohort with AKI. The median age for children with NSAID-associated AKI was 14.7 years and four patients were younger than 5 years. Of the 20 children for whom dosing data were available, 75 percent received NSAIDs within recommended dosing limits. Dialysis, intensive care unit admission, and longer length of stays were significantly more likely in children younger than 5 years of age.

"NSAID-associated AKI accounted for 2.7 percent of AKI in this pediatric population," the authors write. "AKI typically occurred after the administration of correctly dosed NSAIDs. Young children with NSAID-associated AKI may have increased disease severity."
 

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Further Reading
Use of triple therapy comprising diuretics and angiotensin converting enzyme inhibitors, or angiotensin receptor blockers, together with nonsteroidal anti-inflammatory drugs is associated with an increased risk of acute kidney injury, particularly in the first 30 days of treatment, according to a study published online Jan. 8 in BMJ.
A U.S. Food and Drug Administration advisory panel met Thursday and Friday to discuss the fate of certain painkillers that contain the opioid known as hydrocodone, concluding in a vote in favor of moving hydrocodone combination products into the more restrictive Schedule II category of controlled substances.
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