A Case Report on

Diclofenac Induced
Chronic Kidney
Disease
Vanishree Prakash Babladi, Neelkanthreddy
Patil, Manjunath G, Pooja V S Nalimat, Sheetal R
Ninne, K Muteshwara
ALISYA NADHILAH CHAIRUL NOOR
030.15.013
Trisakti Universiy – Faculty of Medicine
Internal Medicine Rotation
RSUD Karawang
INTRODUCTION
Non-steroidal Anti-inflammatory Drugs (NSAID)
are on of the most commonly prescribed drugs
and their nephrotoxic effects are well known

Diclofenac is one of the Non-steroidal anti

inflammatory drugs that exert anti-inflammatory,
analgesic, and antipyretic effetcs through the
suprresion of prostaglandin synthesis, by inhibiting
the enzyme cyclooxygenase
 Chronic kidney disease is
defined as either kidney damage
DEFINTION

or a decreased Glomerular
Filtration Rate (GFR) of less than
60 ml/min/1.73m2 for at least 3
months
 CASE PRESENTATION
The patient is a 65-
year-old male
• CHIEF COMPLAINT:
Bilateral lower limb
swelling since 15 days
- He had swelling in right
foot before and followed
by left foot next day
morning
• ADDITIONAL COMPLAINT:
- Facial swelling
.
 • Had a wound on his right foot 25
days ago and has taken treatment
Tab. Diclofenac 50 mg and first aid
• Was diagnosed Chikungunya 3 years
ago and was on medication
Tab.Diclofenac and Tab.
Dexamethasone 0,5 mg
• Had consumed Tab.Diclofenac for
3 years
• Started taking the medicine
Tab.Diclofenac and Paracetamol
for almost one year
 PHYSICAL
EXAMINATION
• VITAL SIGNS : HYPERTENSION STAGE 2
(180/100 mmHg)

• GENERALIZED STATUS
EXTREMITY: PITTING TYPE EDEMA
LABORATORY INVESTIGATON
 DIAGNOSIS
Drug Induced Grade 4 chronic kidney
disease
Hypertension
Bilateral lower limb cellulitis
Anemia
 DISCUSSION
• NSAID drugs alter renal functions through
their renal prostaglandins leading reversible
renal ischemia

• Although NSAID related hypertension, salt

and water retention, edema, and
hyperkalemia are highly infrequent but they
remain a concern in patient who are at risk
and can develop renal failure

• In this case, kidney disease and overuse of

Diclofenac may account for the increse in
blood pressure
 CONCLUSION
• Diclofenac have been reported to cause
nephrotoxicity which is considered as
significant adverse effect

• Monitoring of renal function and serum

creatinine levels is mandatory during
therapy, together with assesment of
electrolytes and blood pressure
 REFERENCES
Vanishree Prakash Babladi,
Neelkanthreddy Patil, Manjunath G,
Pooja V S Nalimat, Sheetal R Ninne,
K Muteshwara. (2019). A case report
on diclofenac induced chronic
kidney disease. Ind Journal. 12(2):129-
132.