Department of Internal Medicine, Sendai City Hospital, Japan.
Department of Nephrology, JR Sendai Hospital, Japan.
Intern Med. 2022 Nov 1;61(21):3239-3243. doi: 10.2169/internalmedicine.9011-21. Epub 2022 Mar 12.
We herein report a case of acute kidney injury (AKI) due to tubulointerstitial nephritis (TIN) after starting empagliflozin in a diabetic patient. The patient developed stage 1 AKI with proteinuria and elevated tubulointerstitial markers. A renal biopsy showed acute TIN with lymphocytic infiltration into the interstitium. The patient's renal function improved after discontinuation of empagliflozin and steroid administration. Sodium-glucose cotransporter 2 (SGLT2) inhibitor-induced AKI has been reported, but the underlying mechanism remains unclear, potentially because few patients with SGLT2-inhibitor-induced AKI have undergone a renal biopsy. We report the present case in the hope that it will help clarify the mechanism.
我们在此报告一例糖尿病患者起始使用恩格列净后发生的伴发小管间质性肾炎的急性肾损伤(AKI)。该患者出现 1 期 AKI,伴有蛋白尿和肾小管间质性标志物升高。肾活检显示急性 TIN,间质中有淋巴细胞浸润。停用恩格列净和给予类固醇后,患者的肾功能改善。已有钠-葡萄糖共转运蛋白 2(SGLT2)抑制剂相关 AKI 的报道,但潜在机制仍不清楚,可能是因为接受 SGLT2 抑制剂相关 AKI 肾活检的患者较少。我们报告本病例,希望有助于阐明其机制。