Renal papillary necrosis induced by naproxen

Pediatr Nephrol. 2003 Aug;18(8):826-9. doi: 10.1007/s00467-003-1167-4. Epub 2003 May 28.

Abstract

A 17-year-old healthy girl was admitted to our hospital with diffuse abdominal pain and decreased oral intake of about 11 days duration. About a week prior to admission, she had taken naproxen, 250 mg four times a day for 4 days. Physical examination was normal except for diffuse abdominal tenderness on deep palpation. Investigations revealed high serum BUN (42 mg/dl) and creatinine (4.0 mg/dl). Serum electrolytes and complement (C3, C4) levels and urinalysis were normal. Antinuclear-antibody and anti-dsDNA were negative. Kidney biopsy revealed renal papillary necrosis, acute tubular necrosis, and focal interstitial nephritis. A diagnosis of nonoliguric acute renal failure due to naproxen nephrotoxicity was made. She received intravenous hydration, and oral steroids, which was gradually discontinued in 3 months. A follow-up at 4 months revealed normal renal function with a serum creatinine of 1.1 mg/dl, BUN 7 mg/dl, and normal urinalysis. The report highlights a need for caution while using naproxen or any other nonsteroidal anti-inflammatory drugs, even for a short duration.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / pathology
  • Adolescent
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Female
  • Humans
  • Kidney Medulla / pathology*
  • Naproxen / adverse effects*
  • Necrosis

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Naproxen