Suchitra Pal
1* 
, Santhna Letchmi Panduragan
2 , Faridah Mohd Said
1 1 Faculty of Nursing, Lincoln University College, No. 12-18, Jalan SS 6/12, off Perrbandaran 47301 Petaling Jaya, Selangor DarulEhsan, Malaysia
2 Faculty of Nursing, University of Cyberjaya, Selangor, Malaysia
Abstract
Self-medication is currently a growing global healthcare concern with varying degree of prevalence. Prolonged unsupervised self-medication can sometimes lead to adverse consequences. Our case report allows an in-depth examination of experience of a patient with unsupervised prolonged self-medication that caused an unfortunate adverse consequence. The case report identifies deficiencies in knowledge and practice concerning medication adherence, with a focus on the prolonged self-medication with analgesics. We are presenting here a case of self-medication and non-adherence to medical advice, which had resulted in chronic kidney disease (CKD) in a young male patient. The patient was admitted with rectal bleeding. Laboratory findings revealed elevated serum creatinine (2 mg/dL) and urine albumin-creatinine ratio of 121.7 mg/g indicating CKD as associated findings. However, the serum potassium was within normal range (4.5 mEq/L). During discharge the above parameters did not changed much (creatinine 1.9 mg/dL and serum potassium 4.7 mEq/L). However, the patient subsequently failed to attend the follow-up clinic at a regular interval. Instead, he continued self-medication with oral diclofenac sodium, a nonsteroidal anti-inflammatory drug (NSAID) to reduce toothache. The prolonged two years use of NSAIDs for toothache might have led to development of chronic renal failure. The finding from this case study highlights the importance regarding possession of basic knowledge about adherence to safe as well as supervised medication practice, and compliance to follow up.
Implication for health policy/practice/research/medical education:
Education: Educational programs aimed at raising the awareness about the adverse impacts of self-medication may help to reduce this bad practice among the patients. Practice: Enforcing the safe medicine practice will influence decision-making policies, protocols as well as interventional strategies to raise the awareness about the adverse impacts of self-medication. Research: To acquire more data to defend such practice will drive conduction of further research on this topic to develop protocols and guideline on self-medication and adherence to follow up.
Please cite this paper as: Pal S, Panduragan SL, Said FM. Chronic kidney injury caused by unsupervised and unregulated self-medication of nonsteroidal anti-inflammatory drugs; a case report and literature review. J Renal Inj Prev. 2025; x(x): e38419. doi: 10.34172/jrip.2025.38419.