Ketorolac-induced Acute Renal Failure in a Previously Healthy Adolescent

Ketorolac has become an important component of analgesic regimens for children as well as adults because of its lack of adverse effects on respiratory, cardiovascular, and neurologic function. Although initially used parenterally in hospitalized patients, the development of an oral ketorolac dose form extended its use to the outpatient setting, where its potency has been considered an advantage over traditional therapies.1-3 Several cases of hyperkalemia and oliguric acute renal failure associated with ketorolac use have been reported in the medical literature.4-12 Elderly hospitalized patients receiving large doses of ketorolac intramuscularly (IM) after major surgery seem to be at greatest risk.