Diclofenac sodium associated acute kidney injury

Abstract

A 63-year-old male patient presented with diarrhea at the previous night after taking colchicine by himself for acute gout attacks and then he changed to take diclofenac sodium himself (75 mg twice daily) for 3 days. On the third day after diclofenac sodium treatment, nausea and vomiting occurred, then the drug was stopped (the total dose was 375 mg). Two days after the drug withdrawal, the patient successively developed reduced urine output and chest discomfort. Laboratory tests showed serum creatinine 758.4 μmol/L, blood urea 13.9 mmol/L, and blood potassium 3.1 mmol/L. He was diagnosed as having acute kidney disease (AKI) and was admitted to the Department of Nephrology. After admission, he received oral compound α-Ketoacid tablets (4 pills thrice daily), benidipine tablets (4 mg once daily) and Jinshuibao capsules (金水宝胶囊, 1.98 g thrice daily), and was asked to drink more water. On the 7th day after the drug withdrawal, renal biopsy was performed and the histopathological examination result of renal tissue showed acute tubular damage. The above-mentioned treatments were continued and the patient′s renal function was improved gradually. On the 24th day after diclofenac sodium withdrawal, his serum creatinine was 89 μmol/L and blood urea was 7.5 mmol/L. Diclofenac sodium-associated AKI was considered. Key words: Diclofenac; Anti-inflammatory agents, non-steroidal; Acute kidney injury