Acute renal papillary necrosis induced by ibuprofen.

Several specific renal syndromes may be induced by the interaction of nonsteroidal anti-inflammatory drugs (NSAIDs) upon renal function. We report an NSAID-induced form of acute renal failure that represents a dual mechanism of impact on renal function involving direct parenchymal damage at a renal papillary level and mechanical outflow ureteric obstruction consequent to acute papillary necrosis. This form of NSAID-related acute renal failure has been reported very infrequently. We suspect the syndrome is not often recognized clinically. Clinicians and health care workers need to remind constantly the general public concerning the standard steps to be taken to ensure the proper and safe use of over-the-counter drugs. This is especially important considering the recent FDA approval of the over-the-counter sale of naproxen sodium, ketoprofen, and ibuprofen.