title: Acute renal failure due to sulfinpyrazone.
abstract: A case of sulfinpyrazone-associated acute renal failure is reported. Sulfinpyrazone can cause reversible acute renal failure from acute tubular necrosis in patients with volume depletion. Brown tubular casts on urine microscopy and a fractional excretion of sodium greater than 1 are helpful in the diagnosis. Uric acid nephropathy and allergic interstitial nephritis should be included in the differential diagnosis of sulfinpyrazone-associated acute renal failure. Acute reduction of renal blood flow due to inhibition of renal prostaglandin synthesis and kallikrein activity by the drug is a possible mechanism. Treatment of sulfinpyrazone-induced acute tubular necrosis consists of intravascular hydration, supportive care, and withholding sulfinpyrazone. The patients at risk for acute renal failure due to sulfinpyrazone are those who have intravascular volume depletion as sensed by the kidneys.
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center and Veterans Affairs Medical Center, Nashville, Tennessee 37232-2372, USA.
authors.forename: M
authors.initials: M
authors.lastname: Walls
authors.forename: S
authors.initials: S
authors.lastname: Goral
authors.forename: W
authors.initials: W
authors.lastname: Stone
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D015210:Arthritis, Gouty / Q000188:drug therapy; D006801:Humans; D007610:Kallikreins / Q000378:metabolism; D007683:Kidney Tubular Necrosis, Acute / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D011453:Prostaglandins / Q000652:urine; D012079:Renal Circulation / Q000187:drug effects; D013442:Sulfinpyrazone / Q000009:adverse effects*; D014528:Uricosuric Agents / Q000009:adverse effects*
chemical_list: D011453:Prostaglandins; D014528:Uricosuric Agents; D007610:Kallikreins; D013442:Sulfinpyrazone