A Case of Nephrotic Syndrome with Acute Renal Failure Induced by Tramadol HCl/Acetaminophen

Korean Journal of Nephrology 2010;29(5):623-627.

Young Ki Son, M.D.1, Young Hee Nam, M.D.1, Su Mi Lee, M.D.1, Hye In Kim, M.D.1, Won Suk An, M.D.1, Seong Eun Kim, M.D.1, Ki Hyun Kim, M.D.1 and Seo Hee Rha, M.D.2

Department of Internal Medicine¹
Department of Pathology²
Dong-A University College of Medicine, Busan, Korea

증례 : Tramadol HCl/acetaminophen 복합제에 의한 급성신부전을 동반한 신증후군 1예

손영기1, 남영희1, 이수미1, 김혜인1, 안원석1, 김성은1, 김기현1, 나서희2

동아대학교의료원 내과학교실1 , 해부병리학교실2

Abstract

Analgesics are used commonly because of their beneficial effects on various disease processes and pain control, and so the population of patients who are at risk for adverse effects of these drugs is rapidly expanding. A number of renal problems have been associated with the use of these drugs, including electrolyte imbalance, acute renal failure, nephrotic syndrome, and interstitial nephritis. We experienced a 65-year-old female patient who developed general edema and oliguria for 4 days and diagnosed as focal segmental glomerulosclerosis with interstitial nephritis. She had taken tramadol HCl/acetaminophen (UltracetⓇ) for 15 days before admission. Renal biopsy revealed that focal tubular atropy, focal interstitial fibrosis and evidence of diffuse inflammatory cell infiltrations. Tramadol HCl/acetaminophen (UltracetⓇ) was discontinued on admission because of the likelihood the renal disease was drug-related and the patient improved after discontinuation of this drug without remained renal damage. This case suggests that UltracetⓇ must be an agent that causes nephrotic syndrome with acute renal failure. Therefore clinicians should use it with caution in high risk patients.

Key Words: Analgesics, Nephrotic syndrome, Acute renal failure