Acute flank pain and reversible renal dysfunction associated with nonsteroidal anti-inflammatory drug use

A 14-year-old boy and a 12-year-old girl were found to have flank pain and reversible kidney dysfunction associated with use of nonsteroidal anti-inflammatory drugs (NSAIDs). Flank pain can be a symptom of kidney problems. The boy had been treated with the NSAID flurbiprofen for ankle pain caused by sports activities and the girl had been given meperidine, acetaminophen and ibuprofen for neck and shoulder muscle pain. NSAIDs are used in adults and have well-known toxic effects on the kidneys. They are used less often in the treatment of children. Serious nephrotoxic effects are seldom reported. The use of NSAIDs in pediatrics patients may grow because NSAIDs such as ibuprofen are available without a prescription in liquid pediatric formulations and are being marketed for fever control. Although standard doses of NSAIDs are generally considered safe in healthy individuals, the side effects experienced by these healthy children are the same as those described in adult patients exposed to suprofen. NSAIDs have the potential for harming the kidneys even in normal patients and should be used with caution.