Furosemide Orlistat And Nsaids Too Much For

Case Report

Furosemide, orlistat and NSAIDS - too much for the Kidneys to handle

Presented by Adnan Akram Prepared for Prof. I. Folkmane Department of Nephrology. Dept of Int Medicine

Riga 2009

Patient

Anamnesis Morbi 60 Year old female presented with RPGN on August 2008

Anamnesis Morborum Age 18, 120 Kg Age 22, 122 Kg Age 60, 52 Kg

Drug History Furasamide @ 18 Yrs 40 - 60 mg / day, proceeding 5 years 1000 mg / day Orlistat 120 - 240 mg/day 3 years NSAIDS self treated for acute ankle monoarthritis Entericoxid 90 mg/day for 1 month - severe Oral Prednisolone 40 mg / day for 3 weeks (no improvement)

Objective Anamnesis no more tenses, no oedemas

Abdominal XRay No calcification of kidneys US without any patology Diet Plan 30g of protein/day + 50 KCal

Blood Analysis EO - Normal range, K+ 5-5.5 mEq/l HCO3 20 mEq/l Ca++ Mg++ Normal range

Renal Biopsy - moderate to severe chronic interstitial fibrosis & tubular atrophy with a secondary global glomerulosclerosis Extensive intratubular calcifications - Immunofluoresence test -ve Management Patient on Chronic Haemodialysis, Psychiatric consultation before renal implant