Ketoroclac-induced irreversible renal failure in sickle cell disease: a case report

Nonsteroidal anti-inflammatory drugs are often used in the management of th ose with acute pain secondary to sickle cell disease due to potent analgesi c effects along with a lack of addictive potential, respiratory depression, and central nervous system effects, as may occur with narcotics. Caution s hould be observed in the use of nonsteroidal anti-inflammatory drugs in pat ients with compromised renal function. We present a case of a 17-year-old s ickle cell disease patient with an acute painful episode and normal renal f unction indices who subsequently developed irreversible renal failure and a perirenal hematoma following the administration of ketorolac, despite adeq uate hydration. Due to its inhibitory effect on prostaglandin-mediated vaso dilation, we advise caution in the use of ketorolac for the pain management of sickle cell painful episodes. We recommend following the administration guidelines for ketorolac for renal-compromised patients in those with pain ful episodes of sickle cell disease, and if used in this patient population , renal function must be very closely monitored.