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- Title
Nephrotoxicity with cyclooxygenase 2 inhibitor use in children.
- Authors
Fletcher, Jeffery T.; Graf, Nicole; Scarman, Anthony; Saleh, Hamda; Alexander, Stephen I.
- Abstract
The nephrotoxic potential of anti-inflammatory drugs alone and in compound preparations has been known for over fifty years. Nephrotoxicity associated with selective cyclooxygenase 2 (COX-2) inhibitor use is reported in adult patients but not in children. We present here the first report of reversible acute renal failure associated with the COX-2 inhibitor rofecoxib (Vioxx) in three children. Patient 1, an 18 month old girl with neonatal Bartter syndrome, developed acute renal failure with a peak creatinine of 1.9 mg/dl (164 μmol/l) and severe hyperkalemic metabolic acidosis. Patient 2, a 14 year old boy with a history of rheumatic fever, developed acute renal failure with a peak creatinine of 2.7 mg/dl (240 µmol/l). While patient 3, a healthy 14 year old girl, developed acute renal failure and tubulointerstitial nephritis confirmed on renal biopsy with a peak creatinine of 3.3 mg/dl (287 µmol/L). All children had been taking non-selective non-steroidal anti-inflammatory drugs (NSAID’s) immediately prior to rofecoxib use. Renal function returned to normal within one week in all three patients and has remained normal at follow-up. This paper highlights the nephrotoxic risk of COX-2 inhibitor use in the pediatric population.
- Subjects
NEPHROTOXICOLOGY; KIDNEY diseases; ANTI-inflammatory agents; CYCLOOXYGENASE 2 inhibitors; CHILDREN; PEDIATRIC nephrology
- Publication
Pediatric Nephrology, 2006, Vol 21, Issue 12, p1893
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-006-0252-x