接受 exenatide 治疗后发生的急性肾小管间质性肾炎。

Acute tubulointerstitial nephritis following treatment with exenatide.

机构信息

Renal Unit, Liverpool Hospital, Liverpool Department of Nephrology, St Vincent's Hospital, Sydney, Australia.

出版信息

Diabet Med. 2013 Jan;30(1):123-5. doi: 10.1111/j.1464-5491.2012.03738.x.

DOI:10.1111/j.1464-5491.2012.03738.x

PMID:22762797

Abstract

BACKGROUND

Acute tubulointerstitial nephritis, a cause of acute kidney injury, is seen occasionally following treatment with medications such as antibiotics and non-steroidal anti-inflammatory drugs. To date, the development of biopsy-proven acute tubulointerstitial nephritis after treatment with exenatide has not been reported.

CASE REPORT

A 58-year-old man was prescribed exenatide for poorly controlled Type 2 diabetes mellitus. He subsequently developed deterioration in kidney function, with the estimated glomerular filtration rate declining from 59 to 39 ml min(-1) 1.73 m(-2) over 2 months. Despite cessation of exenatide, there was continued deterioration in estimated glomerular filtration rate to 16 ml min(-1) 1.73 m(-2). He underwent renal biopsy and the sections showed active diffuse tubulointerstitial nephritis with infiltration of eosinophils. He was treated with prednisolone over several months with incomplete recovery in kidney function.

CONCLUSION

Acute tubulointerstitial nephritis should be suspected if there is deterioration in kidney function in a patient treated with exenatide in the absence of other causes of acute kidney injury such as dehydration or hypotension.

摘要

背景

急性肾小管间质性肾炎是急性肾损伤的一个原因，偶尔会在使用抗生素和非甾体抗炎药等药物治疗后出现。迄今为止，尚未有报道称在使用 exenatide 治疗后出现经活检证实的急性肾小管间质性肾炎。

病例报告

一名 58 岁男性因 2 型糖尿病控制不佳而被开处 exenatide。随后，他的肾功能恶化，肾小球滤过率（eGFR）从 59 ml min(-1) 1.73 m(-2) 在 2 个月内下降至 39 ml min(-1) 1.73 m(-2)。尽管停止使用 exenatide，但 eGFR 仍持续恶化至 16 ml min(-1) 1.73 m(-2)。他接受了肾活检，切片显示弥漫性活动性肾小管间质性肾炎伴嗜酸性粒细胞浸润。他接受了数月的泼尼松龙治疗，但肾功能未完全恢复。