社團法人臺灣臨床藥學會

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【案例報告】伴有糖尿病腎病變的老年患者使用Diclofenac 造成的急性腎損傷案例報告
A Case Report of Acute Kidney Injury Associated with Diclofenac in an Elderly Patient with Diabetic Nephropathy
急性腎損傷、Diclofenac、糖尿病腎病變
張惠淇Hui-Chi Chang1 、林俊杰Jiun-Jie Lin*2 、黃秀滿Hsiu-Ma Huang1 、陳世欽Shia-Chin Chen1 、陳鴻儀Hung-Yi Chen3.4
1衛生福利部臺中醫院藥劑科 、2衛生福利部豐原醫院藥劑科 、3中國醫藥大學北港附設醫院 、4中國醫藥大學藥學系
非類固醇抗發炎藥物 (nonsteroidal anti-inflammatory drugs, NSAID) 廣泛地被使用,它們的副作用眾所皆知,急性腎損傷 (acute kidney injury, AKI) 可能發生在任何一類的非類固醇抗發炎藥物中。此案例為伴有糖尿病腎病變患者,服用diclofenac 50 毫克,每日三次,治療背部疼痛。使用diclofenac 期間,患者血漿肌酸酐、尿素氮和腎功能惡化。先停用包括diclofenac 在內所有藥物後,再陸續加回其他藥物。一周後,所有數值回復至先前範圍內,並於門診繼續追蹤。
 
Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used in populations and their side effects are well known. Acute kidney injury (AKI) can occur with any class of NSAIDs. A patient with diabetic nephropathy was prescribed tablet diclofenac 50 mg thrice a day for his back pain. Use of diclofenac worsened his plasma creatinine, urea nitrogen (BUN) and other tests about kidney functions. Following the deranged report, his medications including diclofenac were stopped. After one week, all the values dropped back to the previous range observed at his outpatient follow-up.
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