Renal necrosis papillary

NSAIDs can cause renal insufficiency when administered to patients whose renal function depends on prostaglandins. Patients with chronic renal insufficiency or left ventricular dysfunction, the elderly, and those receiving diuretics or drugs that interfere with the renin-angiotensin system are particularly susceptible. Decreased glomerular filtration also may cause hyperkalemia. NSAIDs rarely cause tubulointerstitial nephropathy and renal papillary necrosis. 

Genitourinary Renal papillary necrosis, hematuria, hyposthenuria, proteinuria, nephritic syndrome, tubular dysfunction,... 

The most common adverse effects involve the GI system (gastritis, bleeding, and perforation), kidneys (renal papillary necrosis, reduced creatinine clearance [CLcr]), cardiovascular system (sodium and fluid retention, increased blood pressure), and CNS (impaired cognitive function, headache, dizziness). 

Acute exposure of rats to high concentrations (up to 40,000 ppm) has resulted in convulsions, pulmonary edema, respiratory arrest, and death. In rats repeatedly exposed at 600 ppm, death was attributed to renal papillary necrosis renal toxicity was not present in rabbits similarly exposed. Exposure of rabbits to 300 or 600 ppm resulted in convulsions and hyperactivity, moderate inflammation of nasal tissues, and some inflammation of the trachea or bronchi. Subchronic studies found that rats exposed at 3 00 ppm had mottled incisor teeth, minimal renal effects, pulmonary histiocytosis, inflammation of nasal tissues, and cerebral vacuolation. 

Renal effects Acute renal insufficiency, interstitial nephritis with hematuria, nephrotic syndrome, proteinuria, hyperkalemia, hyponatremia, renal papillary necrosis, and other renal medullary changes may occur. 

Brix AE Renal papillary necrosis. Toxicol Pathol 2002 30 672. [PMID 12512867]... 

Degenerative changes occur in many organs of rats after administration of aziridine by various routes, including inhalation (lARC, 1975). Acute renal papillary necrosis is produced in rats and dogs administered aziridine. At low doses in rats, there was necrosis of interstitial cells, thin limbs of the loops of Henle and vasa recta, while collecting ducts were spared. At higher doses, there was total papillary necrosis (Ellis et al., 1973 Ellis Price, 1975 Axelsen, 1978). 

Axelsen, R.A. (1978) Experimental renal papillary necrosis in the rat the selective vulnerability of medullary structures to injury. Virchows Arch. A. Pathol. Anal, 381,79-84... 

Ellis, B.G. Price, R.G. (1975) Urinary enzyme excretion during renal papillary necrosis induced in rats with ethyleneimine. Chem.-biol. Interact., 11, 473-482... 

S.D. Lenz, and W.W. Carlton, Diphenylamine-induced renal papillary necrosis and necrosis of the pars recta in laboratory rodents. Vet. Pathol. 27 71-178, 1990. 

Small numbers of lipid droplets (representing neutral lipid, lipoprotein or phospholipid) are considered normal in dogs, cats, mice and humans (Gross et al. 1991 Streather et al. 1993 Finco 1997). Increased excretion of lipid droplets (which may cause increased urine turbidity) may indicate glomerular injury (de Mendoza et al. 1976 Gherardi and Calandra 1982). Increased urinary phospholipid excretion (confirmed by thin layer chromatography) may indicate early papillary injury/renal papillary necrosis in rodents (Thanh etal. 2001). 

Thanh NTK, Stevenson G, Obatomi DK et al. (2001) Urinary lipid change during the development of chemically induced renal papillary necrosis. A study using mefenamic acid and N-phenylantranihc acid. Biomarkers 6 417-427 Weingand K, Brown G, Hall R et al. (1996) Harmonization of animal clinical pathology testing in toxicity and safety studies. Fund Appl Toxicol 29 198-201... 

Rodenticide A pesticide or other agent used to kill rats and other rodents or to prevent them from damaging food, crops, or forage RPN Renal papillary necrosis RRRs (3R) Reduce, reuse, and recycle RUP See Restricted-use pesticide... 

Gunson, D.E., Soma, L.R. (1983). Renal papillary necrosis in horses after phenylbutazone and water deprivation. Vet. Pathol. 20(5) 603-10. 

Renal papillary necrosis and interstitial nephritis with the nephrotic syndrome have been documented (27,28). Other cases of the nephrotic syndrome, with or without renal insufficiency, which were apparently due to minimal-change nephropathy (which is relatively more common in NSAID users), have been reported (29,30). The unusual feature of diclofenac-associated renal interstitial mucinosis has been described (SEDA-17, 109). 

Interstitial nephritis with the nephrotic sjmdrome and one case of renal papillary necrosis have been recorded (SEDA-12, 86) (SEDA-17, 110). Flurbiprofen can cause a membranous nephropathy (SEDA-21,105). 

Probable indometacin-induced renal papillary necrosis has been described in two patients with chronic juvenile arthritis (SEDA-8,103). 

Mefenamic acid and other anthranihc acid derivatives are nephrotoxic. Many renal effects have been demonstrated in animals. Acute renal insufficiency, renal papillary necrosis, and non-oliguric renal insufficiency have been reported in man (11,12). Renal biopsies in renal insufficiency have shown interstitial nephritis, mesangial proliferation, and focal pedicle fusion, previously undescribed (13). 

NSAIDs can produce a spectrum of renal diseases functional renal insufficiency, nephrotic syndrome with or without interstitial nephritis, renal papillary necrosis and... 

Renal papillary necrosis has been reported after longterm intake or abuse of aspirin and other NSAIDs (SEDA-11, 85) (SEDA-12, 79). 

The relation between long-term heavy exposure to analgesics and the risk of chronic renal disease has been the object of intensive toxicological and epidemiological research for many years (SEDA-24, 120) (159). Most of the earlier reports suggested that phenacetin-containing analgesics probably cause renal papillary necrosis and interstitial nephritis. In contrast, there is... 

NSAID-induced renal toxicity, comprising interstitial nephritis and renal papillary necrosis. The condition, named analgesic nephropathy, was not uncommon and was serious. In a number of cases malignancies in the urinary tract also occurred. 

Renal papillary necrosis with retroperitoneal fibrosis secondary to analgesic abuse (involving aspirin, propoxyphene, and numerous other analgesics taken in large quantities for many years) has also incidentally been reported (SEDA-7, 94). 

McCredie M, Stewart JH. Does paracetamol cause uro-thehal cancer or renal papillary necrosis Nephron 1988 49(4) 296-300. 

Hoffbrand Bl. Dapsoneand renal papillary necrosis. British medical journal. 1978 Jan 14 1(6105) 78. 

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