Korean J Nephrol.  2006 Mar;25(2):317-320.

Acute Bilateral Renal Cortical Necrosis Associated with Diclofenac Sodium

• Yun JC
• Baek JE
• Jung EY
• Lee DW
• Jeong YY
• Chang SH
• Lee JD
• Kim HJ
• Park DJ

Abstract

Acute bilateral renal cortical necrosis is relatively unusual cause of acute renal failure (ARF). We report a rare case of acute bilateral renal cortical necrosis associated with diclofenac sodium. A 57-year-old man visited to our hospital with progressive oligoanuria for three days. Four days earlier, after diclofenac sodium 150 mg was injected intramuscularly at local hospital, he experienced anaphylactic shock. Our laboratory findings revealed the existence of fibrin split, thrombocytopenia, coagulopathy, and microangiopathic hemolytic anemia (MAHA). These findings were compatible with disseminated intravascular coagulation (DIC). The radiocontrast enhancement CT scan showed a bilateral lack of enhancement of the renal cortex after contrast infusion, enhancement of renal medulla, and the absence of renal excretion of the contrast dye. Renal biopsy showed a cortical necrosis with congested acellular glomuruli and necrotic tubules. Empiric treatment including hemodialysis was commenced. Although his renal function was not completely recovered, he is now being followed up at this hospital without dialysis.

Keyword

Renal cortical necrosis; Acute renal failure; Diclofenac

MeSH Terms

Acute Kidney Injury
Anaphylaxis
Anemia, Hemolytic
Biopsy
Dialysis
Diclofenac*
Disseminated Intravascular Coagulation
Estrogens, Conjugated (USP)
Fibrin
Humans
Kidney Cortex Necrosis*
Middle Aged
Necrosis
Renal Dialysis
Thrombocytopenia
Tomography, X-Ray Computed
Diclofenac
Estrogens, Conjugated (USP)
Fibrin