Three years ago, physicians specializing in kidney diseases at Riley Hospital for Children in Indianapolis noticed a recurring problem in their patients: Children who had been given ibuprofen at home were experiencing kidney injuries.

Chad Knoderer, now an associate professor of pharmacy practice at Butler University, was a consultant for a physician group at Riley at the time. He joined researchers from the Indiana University School of Medicine to study how often drugs like ibuprofen were causing kidney injuries in their patients.

“This is such an important issue because the drugs are over the counter, so they are easily available,” Knoderer said. “Even young adolescents could buy ibuprofen on their own without knowing about the risks.”

According to the study, which was published in the Journal of Pediatrics on Jan. 25, non-steroidal anti-inflammatory drugs (NSAIDs)—drugs such as ibuprofen, Aleve, and naproxen—can cause significant kidney injury in sick children, especially those with dehydration from flu or other illnesses.

Researchers examined more than 1,015 cases at Riley Hospital for Children at IU Health in Indianapolis over the past three years using data as far back as 1999. The study is considered the first large-scale study of the incidence and impact of acute kidney injury caused by NSAIDs, according to a recent IU School of Medicine press release.

The team of researchers found that 3 percent of admitted kidney injury patients suffered kidney injuries due to having taken NSAIDs, and that these patients are likely an underestimate of the number of children affected.

Researchers also found that three-fourths of the patients were taking NSAIDs for less than seven days, revealing that the negative effects of the drugs happened quickly. Children under 5 years old are at a higher risk for needing dialysis and admittance to the intensive care unit of a hospital, the study found.

Three-fourths of the patients also took the correct dosage as indicated on the label.

“This tells us that the parents did everything right according to the label,” Knoderer said. “So now we have a problem that happens quickly and it happens even when the medication is taken as instructed.”

Researchers found that medical costs were driven up by these cases as well, with at least $375,000 being spent on the NSAID-associated kidney injury cases at Riley Hospital over the study period.

“Even though they are over-the-counter drugs being taken correctly, this study tells us that additional education might be necessary and extremely beneficial to parents and young teens,” Knoderer said.

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