Renal papillary necrosis in a child with rheumatic carditis treated with aspirin.

A child with rheumatic carditis developed acute renal failure due to renal papillary necrosis while receiving a short course of aspirin treatment. It is suggested that in this child the aspirin therapy predisposed the renal medulla to hypoxic damage induced by the carditis and congestive heart failure. It is therefore recommended that children receiving aspirin or other nonsteroidal anti-inflammatory drugs, even for a short time, be closely observed and the drug discontinued of hypoxia is evident. Moreover, during illnesses tending to cause hypoxia such as carditis, aspirin or other nonsteroidal anti-inflammatory drugs are best avoided since they are additional risk factors for renal damage.