Q. If a person with chronic kidney disease receives Toradol 60 mg,can that lead to acute renal failure?

Answered by
Dr. Anshul Varshney
and medically reviewed by iCliniq medical review team.

Hello doctor,

If a person with chronic kidney disease with a creatinine of 1.9 and a GFR of 40 receives Toradol 60 mg IM as a single dose, can that lead to acute renal failure? How soon would failure occur after the administration of the medication?

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology

Hi,

Welcome to icliniq.com.

  • Toradol contains Ketorolac. It is known to cause worsening of kidney functions.
  • But usually what is seen is that, it is the administration for a longer duration which causes the increased probability of renal failure and not a single dose.
  • A famous study reveals that ketorolac administered for 5 days or less did not increase the rate of renal failure.
  • However, among patients who were treated with analgesics for more than 5 days, ketorolac may be associated with an elevated rate of acute renal failure.
  • So, in my opinion, that person should drink plenty of water if otherwise not contraindicated, so as to keep the kidneys well hydrated.
  • He/she should get a repeat evaluation of serum creatinine after 3 days of getting the injection (Toradol intramuscular injection).
  • If the acute renal failure has to occur, it usually occurs in the first 3-5 days only.

For further queries, consult a nephrologist online --> https://www.icliniq.com/ask-a-doctor-online/nephrologist

Thank you doctor,

The person is 65 years old. Will the kidneys decompensate quicker?

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology

Hi,

Welcome to icliniq.com.

  • Yes, if we compare the tolerance of a young person's kidneys to a person of 65 years of age, the kidneys of the older would decompensate easily.
  • However, as per my experience and the studies, the single dose would not affect much
  • As discussed earlier, he/she should consume good quantity of water (if not contraindicated) and wait and watch.
  • Get the serum creatinine evaluated after 3 days of exposure.
  • A rise of ≥1.5 times baseline is considered as acute kidney injury.
  • So, take the precautions as discussed. 
  • As far as pain killers are concerned, if he/she requires them, then Tramadol is the best drug which is relatively very safe in kidney dysfunctions.

Take care.

For further queries, consult a nephrologist online --> https://www.icliniq.com/ask-a-doctor-online/nephrologist

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