Ibuprofen or diclofenac is associated with more severe acute kidney injury in nephropathia epidemica

Abstract

Objective. In many parts of Europe, nephropathia epidemica (NE) is an endemic zoonosis. After a flu-like prodrome, this viral disease often manifests with acute kidney injury. Use of non-steroidal anti-inflammatory drugs is discouraged during the disease, but no data from clinical investigations are available on the association between disease course and the use of analgesics. Material and methods. The charts of 59 patients admitted with NE to a hospital in 2007 were retrospectively analysed. Creatinine levels were compared between users of different analgesics. Results. Patients taking analgesics before admission had higher peak creatinine levels, but not after adjustment for confounders. The subgroup taking ibuprofen or diclofenac had higher initial and peak creatinine levels than the group who did not, even after adjustment for confounders. Conclusion. Since NE cannot be accurately diagnosed in the early disease phase, metamizole, acetaminophen or acetylsalicylic acid may be preferable analgesics to ibuprofen or diclofenac for flu-like symptoms in endemic areas.

Key Words::

• acute kidney injury
• analgesics
• diclofenac
• ibuprofen
• nephropathia epidemica
• non-steroidal anti-inflammatory drugs

Acknowledgements

The authors thank Daniella Rozsa MD and Lajos Floro MD for their help in editing the manuscript.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.