Eurasian Journal of Emergency Medicine

Can spesific biomarkers be used to enlighten the major mechanisms of acute high dose diclofenac sodium-related nephrotoxicity? [JAEM]
JAEM. 9999; 0: 0-0 | DOI: 10.4274/eajem.galenos.2021.45467  

Can spesific biomarkers be used to enlighten the major mechanisms of acute high dose diclofenac sodium-related nephrotoxicity?

Sinem Doğruyol1, İlker Akbaş2, Abdullah Osman Kocak3, Serpil Aygormez4, Habip Emrah Leylek5, Sultan Tuna Akgol Gur3, Ozge Ertener6
1Department of Emergency Medicine, Manisa Merkez Efendi State Hospital, Manisa, Turkey
2Department of Emergency Medicine, Bingol State Hospital, Bingol, Turkey
3Department of Emergency Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey
4Department of Biochemistry, Faculty of Veterinary Medicine, University of Kafkas, Kars, Turkey
5Department of Emergency Medicine, Bandırma State Hospital, Balıkesir, Turkey
6Department of Pathology, Faculty of Medicine, Izmir University of Economics, Izmir, Turkey

Aim: The aim of this study was to examine the basic mechanisms that play a role in the acute nephrotoxicity caused by diclofenac sodium.
Materials and Methods: Only water was given to the control group; however, the diclofenac sodium group was group intoxicated by giving water-soluble, 240 mg/kg, oral single dose diclofenac sodium. After 24 hours, all animals were sacrificed and histopathological analyzes were performed. The levels of spesific biomarkers (Vascular endothelial growth factor [VEGF], Nuclear Factor-Kappa B [NF-kB], Matrix Metalloproteinase-9 [MMP-9], Metalloproteinase Tissue Inhibitor-1 [TIMP-1] and Carcinoembryonic antigen [CEA]) that may be related to the nephrotoxicity mechanism were evaluated.
Results: As a result of biochemical analysis we found that VEGF, TIMP-1, NF-kB and CEA levels were significantly higher and MMP-9 levels were significantly lower in diclofenac sodium group compared to control group. Nephrotoxicity related histopathological changes were observed in the sections of diclofenac sodium group.
Conclusion: This study has shown that the biomarkers we evaluated in the diclofenac sodium-induced acute high-dose intoxication model we created can help us to identify the nephrotoxicity and to explain the nephrotoxicity mechanism with the 3 main steps (the hemodynamic-related pathway, the inflammation-related pathway, and the oxidative stress-related pathway). With a simple version of this panel adapted to emergency departments, we may be able to diagnose diclofenac sodium-related nephrotoxicity.

Keywords: Diclofenac Sodium, Intoxication, Nephrotoxicity


Sinem Doğruyol, İlker Akbaş, Abdullah Osman Kocak, Serpil Aygormez, Habip Emrah Leylek, Sultan Tuna Akgol Gur, Ozge Ertener. Can spesific biomarkers be used to enlighten the major mechanisms of acute high dose diclofenac sodium-related nephrotoxicity?. JAEM. 9999; 0: 0-0

Corresponding Author: Sinem Doğruyol, Türkiye


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