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

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(R)) 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(R)) 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(R) must be an agent that causes nephrotic syndrome with acute renal failure. Therefore clinicians should use it with caution in high risk patients.