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Sheth S, Thakur S, Thorat A, et al. Safe and appropriate use of diclofenac in chronic kidney disease: An Indian perspective. J Family Med Prim Care. 2021;10(7):2450-2456doi: 10.4103/jfmpc.jfmpc_2358_20.
Sheth, S., Thakur, S., Thorat, A., & Gupta, P. (2021). Safe and appropriate use of diclofenac in chronic kidney disease: An Indian perspective. Journal of family medicine and primary care, 10(7), 2450-2456. https://doi.org/10.4103/jfmpc.jfmpc_2358_20
Sheth, Sharad, et al. "Safe and appropriate use of diclofenac in chronic kidney disease: An Indian perspective." Journal of family medicine and primary care vol. 10,7 (2021): 2450-2456. doi: https://doi.org/10.4103/jfmpc.jfmpc_2358_20
Sheth S, Thakur S, Thorat A, Gupta P. Safe and appropriate use of diclofenac in chronic kidney disease: An Indian perspective. J Family Med Prim Care. 2021 Jul;10(7):2450-2456. doi: 10.4103/jfmpc.jfmpc_2358_20. Epub 2021 Jul 30. PMID: 34568119; PMCID: PMC8415660.
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J Family Med Prim Care. 2021 Jul;10(7):2450-2456. doi: 10.4103/jfmpc.jfmpc_2358_20. Epub 2021 Jul 30.

Safe and appropriate use of diclofenac in chronic kidney disease: An Indian perspective.

Journal of family medicine and primary care

Sharad Sheth, Sneha Thakur, Anup Thorat, Pankaj Gupta

Affiliations

  1. Head of Nephrology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India.
  2. Medical Advisor, Novartis India Limited, Mumbai, Maharashtra, India.
  3. Franchise Medical Head, Novartis India Limited, Mumbai, Maharashtra, India.
  4. Head Medical Affairs, Novartis India Limited, Mumbai, Maharashtra, India.

PMID: 34568119 PMCID: PMC8415660 DOI: 10.4103/jfmpc.jfmpc_2358_20

Abstract

Pain is most common symptom associated with progressive disorder, chronic kidney disease (CKD), and is usually undertreated during the early stages of CKD. So, present review was conducted to evaluate the challenges for the management of pain in CKD patients and addresses the scope for considering Diclofenac as suitable alternative for pain management in CKD patient. The database PubMed and Google Scholar were searched from 1970 to Dec 2020 for literature published in English and all studies, review articles that examined the use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) in pain management in CKD patients were included. Literatures revealed that there is a considerable challenge in appropriate management of pain in CKD patients include understanding the altered pharmacokinetics and pharmacodynamics of analgesics in CKD patients and the risk of acute interstitial nephritis. The shorter duration of analgesics is acceptable and considered to pose a low risk of acute interstitial nephritis in patients. Considering that Diclofenac has a shorter half-life and high efficacy, it may be well tolerated in patients with CKD. The acceptance of Diclofenac is partly attributed to being a potent COX-2 inhibitor with the lowest IC50 and its rapid onset of action at lowest effective dose. In conclusion, diclofenac may be well tolerated in patients of renal impairment when used at lowest effective dose for shortest dose duration. Diclofenac is worthy of consideration in mild to moderate cases of CKD. For effective pain management, it is vital to evaluate the tolerability and efficacy of the available analgesics critically.

Copyright: © 2021 Journal of Family Medicine and Primary Care.

Keywords: Diclofenac; chronic kidney disease; nsaid; pain; pain management

Conflict of interest statement

Dr. Sharad Sheth has attended advisory boards arranged by Novartis and is a speaker for Novartis initiated scientific speaker programs. Dr. Sneha Thakur, Dr. Anup Thorat and Dr. Pankaj Gupta are full

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