Abstract
A 70–year-old male patient was admitted complaining of weakness and pain in his arms and lower limbs. His serum creatine kinase and serum creatinine were markedly elevated (36,248 IU/L and 2.8 mg/dL, respectively). He had taken dexketoprofen trometamol because of a common cold, which had developed the previous night. Acute kidney injury caused by dexketoprofen-induced rhabdomyolysis was diagnosed by ruling out other possible causes, such as dermato/polymyositis, myxedema, brucellosis, and hepatitis. Dexketoprofen administration was stopped. As diuresis did not restore spontaneously, the patient was treated with I.V. alkaline solutions and mannitol. Hemodialysis was performed because of anuria and severe metabolic acidosis. The patient’s renal function later recovered. In conclusion, dexketoprofen may be a potential risk factor for acute kidney injury and rhabdomyolysis.
References
Ward MM (1988) Factors predictive of acute renal failure in rhabdomyolysis. Arch Intern Med 148:1553–1557
Singh D, Chander V, Chopra K (2005) Rhabdomyolysis. Methods Find Exp Clin Pharmacol 27:39–48
Valles J, Artigas R, Bertolotti M et al. (2006) Single and repeated dose pharmacokinetics of dexketoprofen trometamol in patients with impaired liver function. Methods Find Exp Clin Pharmacol 28 Suppl A:29–36
Nelson H, Katz D, Dunn T et al (2007) Rhabdomyolysis and necrotic bowel after acetaminophen and ibuprofen overdose. Pharmacotherapy 27:608–612
Knobloch K, Rossner D, Gössling T et al. (2005) [Rhabdomyolysis after administration of diclofenac]. Unfallchirurg 108:415–417 [Article in German]
Delrio FG, Park Y, Herzlich B et al (1996) Case report: diclofenac-induced rhabdomyolysis. Am J Med Sci 312:95–97
Leman P, Kapadia Y, Herington J (2003) Randomised controlled trial of the onset of analgesic efficacy of dexketoprofen and diclofenac in lower limb injury. Emerg Med J 20:511–513
Ezcurdia M, Cortejoso FJ, Lanzón R et al (1998) Comparison of the efficacy and tolerability of dexketoprofen and ketoprofen in the treatment of primary dysmenorrhea. J Clin Pharmacol 38(12):65S–73S
Schlondorff D, DeCandido S, Satriano JA (1987) Angiotensin II stimulates phospholipases C and A2 in cultured rat mesangial cells. Am J Physiol 253(1 Pt 1):C113–C120
Jefferson AJ, Schrier RW (2007) Pathophysiology and etiology of acute renal failure. In: Feehally J, Floege J, Johnson RJ (eds) Comprehensive clinical nephrology, 3rd edn. Elsevier, Philadelphia
Olyaei AJ, Bennett WM (2007) Principles of drug dosing and prescribing in renal failure. In: Feehally J, Floege J, Johnson RJ (eds) Comprehensive clinical nephrology, 3rd edn. Elsevier, Philadelphia
Ramachandran S, Giles PD, Hartland A (1997) Acute renal failure due to rhabdomyolysis in presence of concurrent ciprofibrate and ibuprofen treatment. BMJ 314:1593
Eustace JA, Kinsella S (2011) Clinical features and diagnosis of heme pigment-induced acute kidney injury (acute renal failure). Uptodate. Available online http://www.uptodate.com. Cited 12 February 2011
Clouatre Y, Leblanc M, Quimet D et al (1999) Fenofibrate-induced rhabdomyolysis in two dialysis patients with hypothyroidism. Nephrol Dial Transplant 14:1047–1048
Tsai CN, Liu MF, Lin TS et al (2004) Rhabdomyolysis and acute renal failure in a polymyositis patient. Mod Rheumatol 14:422–423
Kibria R, Ahmed S, Ali SA et al (2009) Hypokalemic rhabdomyolysis due to watery diarrhea, hypokalemia, achlorhydria (WDHA) syndrome caused by vipoma. South Med J 102:761–764
Singhal PC, Kumar A, Desroches L et al (1992) Prevalence and predictors of rhabdomyolysis in patients with hypophosphatemia. Am J Med 92:458–464
Eustace JA, Kinsella S (2011) Prevention and treatment of heme pigment-induced acute kidney injury (acute renal failure). Uptodate. Available online http://www.uptodate.com. Cited 16 February 2011
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sav, T., Unal, A., Erden, A. et al. Single-dose-dexketoprofen-induced acute kidney injury due to massive rhabdomyolysis. Int Urol Nephrol 44, 1581–1583 (2012). https://doi.org/10.1007/s11255-011-9982-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-011-9982-1