Acute Renal Failure with Nephrotic Syndrome after Nonsteroidal Anti-Inflammatory Drug

非類固醇止痛劑已知會引起體液及電解質的不正常合併腎衰竭。非類固醇止痛劑也會引起在之前腎功能正常的人產生急性的腎間質腎炎和腎病徵候群，病理檢查結果為微細病變。我們報告一位75歲台灣女性在服用一天兩次250毫克的naproxen九個月後，產生腎病徵候群和急性腎衰竭。經皮腎臟切片檢查結果為急性腎小管間質腎炎及微細病變。病患接受利尿劑和類固醇脈衝療法，之後口服類固醇治療。在住院的第21天，腎功能恢復到正常及水腫消失。出院後，病患持續有少量蛋白尿的情形；在類固醇治療九個月後才獲得完全緩解。在此，我們回顧文獻，探討關於非類固醇止痛劑引發的腎病變的臨床表現、病程與預後。

關鍵字

非類固醇止痛劑；腎病症候群；急性腎間質腎炎

並列摘要

Nonsteroidal anti-inflammatory drugs (NSAIDs) are well known to cause fluid and electrolyte abnormalities and renal failure. NSAIDs also may cause an acute interstitial nephritis and nephrotic syndrome, characterized by histologic pathology consistent with minimal change disease in patients with previously normal renal function. We report a 75 year-old Taiwanese female who developed nephrotic syndrome with acute renal failure after taking one tablet of naproxen (250 mg) twice a day for nine months. The percutaneous renal biopsy revealed acute tubulointerstitial nephritis with minimal change disease. The patient was treated with diuretics and steroid pulse therapy, followed by oral methylprednisolone. Renal function returned to normal range and edema subsided on the 21st hospital day. Low-grade proteinuria persisted after discharge, complete remission was achieved after nine months of steroid therapy. Herein, we review the literature on clinical manifestations, course, and outcome of NSAID induced nephropathy.

並列關鍵字

nonsteroidal anti-inflammatory drugs ； nephrotic syndrome ； acute interstitial nephritis

國際替代計量

Acute Renal Failure with Nephrotic Syndrome after Nonsteroidal Anti-Inflammatory Drug

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