NMA: Nonprescription Medicines Academy

NSAIDs Shown to Be Important Cause of Acute Kidney Injury in Children

April 17th, 2013

In a retrospective chart review encompassing 1,105 children diagnosed with acute kidney injury, nonsteroidal anti-inflammatory drug (NSAID)-associated acute kidney injury accounted for 2.7% of cases and typically occurred after the administration of correctly dosed NSAIDs.

Pediatric patients (18 years of age or younger) were eligible for inclusion in the study if they were hospitalized at Riley Hospital for Children at Indiana University Health between January 1999 and June 30, 2010, and had a recorded International Classification of Diseases, Ninth Revision code for acute kidney injury. In the total cohort, 21 children had clinical, laboratory, and radiographic studies suggesting NSAID-associated acute tubular necrosis, and 6 had findings suggesting NSAID-associated acute interstitial nephritis (27 of 1,015; 2.7%). The median age of children with NSAID-associated acute kidney injury was 14.7 years (range 0.5-17.7 years); 4 patients (15%) were younger than 5 years of age. Of the 20 children for whom dosing data were available, 15 (75%) had received NSAIDs within recommended dosing limits. Patients younger than 5 years of age were more likely to require dialysis (100% vs 0%, P <0.001), intensive care unit admission (75% vs 9%, P = 0.013), and a longer length of stay (median 10 vs 7 days, P = 0.037).

J Pediatr. 2013 Jan 26. [Epub ahead of print]