{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T01:28:23Z","timestamp":1789694903141,"version":"4.0.1"},"reference-count":25,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T00:00:00Z","timestamp":1636761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Over the last decades, the use of over-the-counter analgesics in the general population has increased in Germany. Ibuprofen is one of the most commonly used nonsteroidal anti-inflammatory drug (NSAID) and is frequently prescribed to children as an analgesic and\/or antipyretic. Besides having a well-established safety and efficacy profile when used in appropriate doses, cases of NSAID-induced acute kidney injury (AKI) have been described in the pediatric population, particularly in the context of dehydration and in combination with other drugs. The ingestion of more than 400 mg\/kg is associated with severe or life-threatening toxicity. This report is about two previously healthy adolescents, who developed AKI after taking high daily dose of ibuprofen as a pain reliever without any appropriate medical supervision. With these case reports, in addition to the side effect profiles of this analgesic, we would also like to present a certain therapeutic recommendation that we applied in these patients, and furthermore appeal to pediatricians to strictly set the indications for ibuprofen intake.<\/jats:p>","DOI":"10.3390\/children8111048","type":"journal-article","created":{"date-parts":[[2021,11,14]],"date-time":"2021-11-14T20:48:36Z","timestamp":1636922916000},"page":"1048","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The Risk of Nonsteroidal Anti-Inflammatory Drugs in Pediatric Medicine: Listen Carefully to Children with Pain"],"prefix":"10.3390","volume":"8","author":[{"given":"Olivier","family":"Mboma","sequence":"first","affiliation":[{"name":"Center for Child and Adolescent Medicine, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten\/Herdecke University, 42283 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Wirth","sequence":"additional","affiliation":[{"name":"Center for Child and Adolescent Medicine, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten\/Herdecke University, 42283 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malik","family":"Aydin","sequence":"additional","affiliation":[{"name":"Center for Child and Adolescent Medicine, Center for Clinical and Translational Research (CCTR), Helios University Hospital Wuppertal, Witten\/Herdecke University, 42283 Wuppertal, Germany"},{"name":"Laboratory of Experimental Pediatric Pneumology and Allergology, Center for Biomedical Education and Research, School of Life Sciences (ZBAF), Faculty of Health, Witten\/Herdecke University, 58455 Witten, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.arcped.2007.01.012","article-title":"Ibuprofen in childhood: Evidence-based review of efficacy and safety","volume":"14","author":"Leroy","year":"2007","journal-title":"Arch. Pediatr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e2022398","DOI":"10.1001\/jamanetworkopen.2020.22398","article-title":"Comparison of Acetaminophen (Paracetamol) With Ibuprofen for Treatment of Fever or Pain in Children Younger Than 2 Years: A Systematic Review and Meta-analysis","volume":"3","author":"Tan","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1542\/peds.2008-2869","article-title":"Medication use among children <12 years of age in the United States: Results from the Slone Survey","volume":"124","author":"Vernacchio","year":"2009","journal-title":"Pediatrics"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1007\/s00228-014-1643-8","article-title":"Association between an excess risk of acute kidney injury and concomitant use of ibuprofen and acetaminophen in children, retrospective analysis of a spontaneous reporting system","volume":"70","author":"Yue","year":"2014","journal-title":"Eur J. Clin. Pharm."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1007\/s00467-015-3105-7","article-title":"Ibuprofen-associated acute kidney injury in dehydrated children with acute gastroenteritis","volume":"30","author":"Balestracci","year":"2015","journal-title":"Pediatr. Nephrol."},{"key":"ref_6","unstructured":"Goyal, A., Daneshpajouhnejad, P., Hashmi, M.F., and Bashir, K. (2021). Acute Kidney Injury. StatPearls, StatPearls Publishing."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1590\/2175-8239-jbn-2018-0107","article-title":"Pathophysiological aspects of nephropathy caused by non-steroidal anti-inflammatory drugs","volume":"41","author":"Lucas","year":"2019","journal-title":"J. Bras. Nefrol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2291","DOI":"10.3390\/ph3072291","article-title":"Nonsteroidal Anti-Inflammatory Drugs and the Kidney","volume":"3","year":"2010","journal-title":"Pharmaceuticals"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1038\/ki.2010.89","article-title":"Acute interstitial nephritis","volume":"77","author":"Praga","year":"2010","journal-title":"Kidney Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1007\/s40265-017-0751-z","article-title":"Working Towards an Appropriate Use of Ibuprofen in Children: An Evidence-Based Appraisal","volume":"77","author":"Chiarugi","year":"2017","journal-title":"Drugs"},{"key":"ref_11","unstructured":"Ershad, M., Ameer, M.A., and Vearrier, D. (2021). Ibuprofen Toxicity. StatPearls, StatPearls Publishing."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"39","DOI":"10.2147\/OAEM.S22795","article-title":"The patterns of toxicity and management of acute nonsteroidal anti-inflammatory drug (NSAID) overdose","volume":"3","author":"Hunter","year":"2011","journal-title":"Open Access Emerg. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1016\/S0196-0644(86)80617-5","article-title":"Ibuprofen overdose: 126 cases","volume":"15","author":"Hall","year":"1986","journal-title":"Ann. Emerg. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1097\/PEC.0000000000000768","article-title":"Nonsteroidal Anti-Inflammatory Drug Toxicity in Children: A Clinical Review","volume":"32","author":"Chung","year":"2016","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"40","DOI":"10.23876\/j.krcp.20.074","article-title":"Pediatric acute kidney injury: New advances in the last decade","volume":"40","author":"Sethi","year":"2021","journal-title":"Kidney Res. Clin. Pract."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.3390\/ph3041279","article-title":"Significant Acute Kidney Injury Due to Non-steroidal Anti-inflammatory Drugs: Inpatient Setting","volume":"3","author":"Dixit","year":"2010","journal-title":"Pharmaceuticals"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"13S","DOI":"10.1016\/S0002-9343(99)00113-8","article-title":"Nephrotoxicity of nonsteroidal anti-inflammatory drugs: Physiologic foundations and clinical implications","volume":"106","author":"Whelton","year":"1999","journal-title":"Am. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1046\/j.1365-2125.1999.00869.x","article-title":"Glomerular, tubular and interstitial nephritis associated with non-steroidal antiinflammatory drugs. Evidence of a common mechanism","volume":"47","author":"Ravnskov","year":"1999","journal-title":"Br. J. Clin. Pharm."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1007\/s00431-003-1392-7","article-title":"Acute renal failure after treatment with non-steroidal anti-inflammatory drugs","volume":"163","author":"Ulinski","year":"2004","journal-title":"Eur. J. Pediatr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e189","DOI":"10.1097\/PCC.0b013e3182745675","article-title":"pRIFLE (Pediatric Risk, Injury, Failure, Loss, End Stage Renal Disease) score identifies Acute Kidney Injury and predicts mortality in critically ill children: A prospective study","volume":"14","author":"Soler","year":"2013","journal-title":"Pediatr. Crit. Care Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"77","DOI":"10.2147\/IJNRD.S103785","article-title":"Pediatric acute kidney injury: Prevalence, impact and management challenges","volume":"10","author":"Ciccia","year":"2017","journal-title":"Int. J. Nephrol. Renov. Dis."},{"key":"ref_22","first-page":"2527","article-title":"Diagnosis and Management of Acute Interstitial Nephritis","volume":"67","author":"Kodner","year":"2003","journal-title":"AFP"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1016\/j.jpeds.2012.11.069","article-title":"Nonsteroidal Anti-Inflammatory Drugs Are an Important Cause of Acute Kidney Injury in Children","volume":"162","author":"Misurac","year":"2013","journal-title":"J. Pediatr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1007\/s004310100729","article-title":"Severe reversible renal failure due to naproxen-associated acute interstitial nephritis","volume":"160","author":"Frishberg","year":"2001","journal-title":"Eur J. Pediatr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1136\/adc.2006.103564","article-title":"Using NSAID in volume depleted children can precipitate acute renal failure","volume":"92","author":"John","year":"2007","journal-title":"Arch. Dis Child."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/8\/11\/1048\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:29:44Z","timestamp":1760167784000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/8\/11\/1048"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,13]]},"references-count":25,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["children8111048"],"URL":"https:\/\/doi.org\/10.3390\/children8111048","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,13]]}}}