Exercise-induced acute renal failure associated with ibuprofen, hydrochlorothiazide, and triamterene.
Nonsteroidal anti-inflammatory drugs predispose to acute renal failure in conditions associated with decreased RBF. Such conditions include advanced age, hypertension, chronic renal insufficiency, diuretic use, and any condition decreasing effective circulating volume. Strenuous exercise also causes marked reductions in RBF. The patient discussed developed severe acute renal failure after strenuous exercise and therapeutic doses of ibuprofen and hydrochlorothiazide-triamterene. Urinalysis showed a nephritic sediment with red blood cell casts. Renal biopsy showed acute tubular necrosis and arteriolar nephrosclerosis. Although exercise-associated acute renal failure is uncommon, susceptible patients with exercise-induced renal ischemia and prostaglandin inhibition may develop this complication.
Sanders
L R
LR
Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
D058186:Acute Kidney Injury / Q000139:chemically induced / Q000209:etiology* / Q000503:physiopathology; D002395:Catecholamines / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism; D015777:Eicosanoids / Q000378:metabolism; D006728:Hormones / Q000378:metabolism; D006852:Hydrochlorothiazide / Q000009:adverse effects*; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D007052:Ibuprofen / Q000009:adverse effects*; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D007683:Kidney Tubular Necrosis, Acute / Q000139:chemically induced / Q000209:etiology; D009400:Nephrosclerosis / Q000139:chemically induced / Q000209:etiology; D010003:Osteoarthritis / Q000150:complications / Q000188:drug therapy; D005082:Physical Exertion; D012079:Renal Circulation / Q000187:drug effects; D014223:Triamterene / Q000009:adverse effects*; D014938:Work Capacity Evaluation
D002395:Catecholamines; D016207:Cytokines; D015777:Eicosanoids; D006728:Hormones; D006852:Hydrochlorothiazide; D007052:Ibuprofen; D014223:Triamterene