Using NSAID in volume depleted children can precipitate acute renal failure

Cheri Mathews John ¹, Rajeev Shukla ¹ and Caroline A Jones ^1*

¹ Royal Liverpool Children's Hospital, United Kingdom

^* To whom correspondence should be addressed. E-mail: caroline.jones{at}rlc.nhs.uk.

Accepted 29 January 2007

Abstract

Non-Steroidal Anti-Inflammatory Drugs (NSAID) are ever increasing in popularity in hospital medicine, general practice and are readily available over the counter. The vast majority of healthy children who ingest therapeutic doses of NSAID for a limited duration tolerate them without any significant adverse effects. The risk of renal toxicity is potentially increased in situations where there is a stimulation of the renin-angiotensin system such as volume depletion or pre-existing chronic renal disease. We describe four cases which illustrate this complication occurring in a children’s hospital. We have not proven cause and effect but further research is needed to define the true risk of the potential renal complication of NSAID in patients at risk of dehydration.

Keywords: NSAID, dehydration, intra-vascular volume depletion, renal complications

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