Ibuprofen can increase retention of fluid and
sodium. Renal dysfunction can also be provoked or
worsened by the use of NSAIDs, particularly in cases of
dehydration (Ulinski and Bensman, 2004; Krause et al,
2005; Leroy et al, 2007) A meta-analysis looking at the
safety and tolerability of ibuprofen versus paracetamol
in childhood fever has suggested that both drugs have
similar tolerability profiles in terms of renal side-effects,
implying a low risk. It is advised that ibuprofen should
be used very cautiously in mild renal impairment and
avoided in moderate-to-severe impairment (Paediatric