title: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Internal Medicine, Sigmaringen Community Hospital, Sigmaringen, Germany. wagner.robert.dr@gmail.com
authors: Robert
authors: R
authors: Wagner
authors: Ursel
authors: U
authors: Leicht-Biener
authors: István
authors: I
authors: Mucsi
authors: Karlheinz
authors: K
authors: Seitz
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology*; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D015331:Cohort Studies; D000075202:Contraindications; D003404:Creatinine / Q000097:blood; D004008:Diclofenac / Q000627:therapeutic use; D004177:Dipyrone / Q000627:therapeutic use; D005260:Female; D005858:Germany; D006480:Hemorrhagic Fever with Renal Syndrome / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D000082:Acetaminophen; D004177:Dipyrone; D003404:Creatinine; D001241:Aspirin; D007052:Ibuprofen