Ibuprofen-Induced Renal Tubular Acidosis

Watanabe, Tôru

doi:10.1016/j.ekir.2018.11.021

Cited by 2 publications

(2 citation statements)

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“…The mechanism of ibuprofen-induced RTA relates to inhibition of CAII. [16][17][18][19][20] Carbonic anhydrase II is an enzyme found in both proximal and distal tubules and catalyzes the conversion of carbon dioxide and water into bicarbonate which is then retained in the respective site. 18 Thus, inhibition of CAII may lead to both proximal and distal RTA or a combination of both known as type III RTA.…”

Section: Discussionmentioning

confidence: 99%

Ibuprofen-Induced Renal Tubular Acidosis: Case Report on a Not-So-Basic Clinical Conundrum

Ghimire

Amin

2023

Can J Kidney Health Dis

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Rationale: Renal tubular acidosis (RTA) is a cause of non-anion gap metabolic acidosis (NAGMA) that is infrequently diagnosed and is due to various underlying etiologies that impair the kidney’s ability to retain bicarbonate or excrete acid. Ibuprofen is an over-the-counter non-steroidal anti-inflammatory medication that is used by patients widely for a variety of reasons. Although it is well known that ibuprofen and other non-steroidal anti-inflammatory drugs may have nephrotoxic effects, the role of ibuprofen as a cause of RTA and hypokalemia is not well recognized. Presenting Concerns: A 66-year-old man with chemotherapy-treated lymphoma in remission and ongoing heavy ibuprofen use for chronic pain presented to hospital with a 1-week history of increasing lethargy and otherwise unremarkable review of systems. Investigations showed acute kidney injury, hypokalemia, hyperchloremia, and NAGMA with elevated urinary pH and positive urine anion gap. Diagnoses: The final diagnosis of distal RTA secondary to ibuprofen was made after ruling out gastrointestinal bicarbonate loss and additional secondary causes of RTA, including other medications, autoimmune conditions, and obstructive uropathy. Interventions: The patient was admitted and treated with intravenous sodium bicarbonate for 24 hours with correction of hypokalemia via oral supplementation. His ibuprofen-containing medication was discontinued. Outcomes: His acute kidney injury and electrolyte abnormalities resolved within 48 hours of initiating treatment with concurrent resolution of his lethargy. He was discharged home and advised to stop taking ibuprofen. Lessons Learned: We report a case of patient with hypokalemia and NAGMA secondary to ibuprofen and highlight the importance of monitoring for this side effect in patients taking ibuprofen.

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Section: Discussionmentioning

confidence: 99%

Ibuprofen-Induced Renal Tubular Acidosis: Case Report on a Not-So-Basic Clinical Conundrum

Ghimire

Amin

2023

Can J Kidney Health Dis

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“…We appreciate the comment by Watanabe 1 regarding possible mechanisms that could be associated with ibuprofen-induced renal tubular acidosis. We reviewed the suggested articles and are in agreement that these articles do point to mechanisms of action for carbonic anhydrase inhibition.…”

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confidence: 98%

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Singh

Krause

2019

Kidney International Reports

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Ibuprofen-Induced Renal Tubular Acidosis

Cited by 2 publications

References 5 publications

Ibuprofen-Induced Renal Tubular Acidosis: Case Report on a Not-So-Basic Clinical Conundrum

Ibuprofen-Induced Renal Tubular Acidosis: Case Report on a Not-So-Basic Clinical Conundrum

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