February 6, 2013
Study Looks at Kidney Injuries From NSAIDs in
Hospitalized Children

Indianapolis, IN—Medications commonly administered to children for pain and fever reduction also can cause acute kidney injury (AKI) in some cases, according to a new report.

The study, led by researchers from Indiana University School of Medicine, suggests that nonsteroidal anti-inflammatory drugs (NSAIDs) can be even more risky in children suffering from dehydration, caused by influenza or other illnesses.

In an article published by the Journal of Pediatrics, study authors report that nearly 3% of cases of pediatric AKI over an 11-and-one-half year span could be traced directly to having taken drugs such as ibuprofen or naproxen. Authors point out that this is believed to be the first large-scale study of the incidence and impact of acute kidney injury caused by NSAIDs.

For the retrospective study, all patients hospitalized at Riley Hospital for Children at IU Health from January 1999 to June 2010 were screened for acute kidney injury. Of 1,015 patients with AKI, 27 were identified to have NSAID-associated AKI.

The authors note that 78% of the 27 patients had been using NSAIDs for less than 7 days, and 75% had taken the medication at the correct dosage. Family members reported to researchers that dehydration was a concern in 67% of cases. Children younger than 5 years old appeared to be more severely affected and, therefore, more likely to require dialysis

The researchers point out that while none of the patients died or developed permanent kidney failure, 30% of the children had evidence of mild chronic kidney damage persisting after recovery from AKI.

“These cases, including some in which patients’ kidney function will need to be monitored for years, as well as the cost of treatment, are quite significant, especially when you consider that alternatives are available and acute kidney injury from NSAIDs is avoidable,” said lead author Jason Misurac, MD, a fellow in pediatric nephrology.

In terms of options to NSAIDs, Misurac suggested that, since fever during an infection is, in itself, not dangerous, “one alternative to NSAIDs would be acetaminophen, but another alternative would be no medication at all, at least for a while, to let the body fight the infection.”

U.S. Pharmacist Social Connect