双氯芬酸诱发老年患者快速进行性肾功能衰竭1例报告

C. C., Srirangam Anusha, K. H B
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摘要

(RPRF)快速进行性肾衰竭是指在数天至数周内肾功能迅速丧失。急性肾损伤是在几小时到几天内突然发生的肾功能衰竭或肾损害。非甾体抗炎药和/或对乙酰氨基酚通常用于轻度至中度疼痛管理。据报道,非甾体抗炎药和/或对乙酰氨基酚可引起可逆性急性肾功能衰竭。患者男,68岁,入院时主诉呕吐,呼吸困难4天,腹部疼痛5天,胸部烧灼感,排尿灼热,血尿2周。他是已知的风吹畸形病例,在过去的8年里,他接受双氯芬酸钠片50 mg/对乙酰氨基酚500 mg的联合治疗,每天1次。他被诊断为快速进展性肾衰竭-急性肾损伤,造影剂肾病,膀胱出口梗阻。实验室检查显示血清肌酐、尿素、血液学参数异常,提示伴中性粒细胞性白细胞增多症的正性贫血。在本病例的评估中发现双氯芬酸/对乙酰氨基酚诱发了快速进行性肾功能衰竭。双氯芬酸/对乙酰氨基酚停药后,各项指标均恢复到正常范围,水肿也逐渐减轻,临床好转
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Diclofenac Induced Rapidly Progressive Renal Failure in Elderly Patient – A Case Report
(RPRF) Rapidly progressive renal failure is categorized by a rapid loss of kidney functions over days to weeks. Acute kidney injury is a sudden episode of kidney failure or kidney damage that happens within a few hours to days. Non-Steroidal Anti-Inflammatory Drugs and/or acetaminophen are commonly used in mild to moderate pain management. NSAID and/or acetaminophen have been reported to cause reversible acute renal failure. A 68-year-old male patient brought with the chief complaints on admission of vomiting, breathlessness since 4 days, pain in the abdomen since 5 days, burning sensation in chest, burning micturition, haematuria since 2 weeks. He was a known case of wind-swept deformity and receiving combination of Tablet Diclofenac sodium 50 mg/Acetaminophen 500 mg once a day in the past 8 years for knee pain. He was diagnosed with Rapidly Progressive Renal Failure-Acute Kidney Injury, Contrast induced Nephropathy, Bladder Outlet Obstruction. The laboratory investigations show abnormality in the serum creatinine, blood urea, haematological parameters indicate normocytic normochromic anaemia with neutrophilic leucocytosis. In the assessment of this case it was found that Diclofenac/Acetaminophen has induced Rapidly Progressive Renal Failure. After withdrawal of Diclofenac/Acetaminophen all the values returned within the normal range and his oedema was also subsiding, showing clinical improvement with
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