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奥利司他致草酸盐晶体相关性急性肾损伤 1 例报告。

Oxalate crystal-related acute renal injury caused by orlistat: A case report.

机构信息

Department of Nephrology, Second Xiangya Hospital, Central South University; Institute of Nephrology, Central South University, Changsha 410011, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2022 May 28;47(5):583-587. doi: 10.11817/j.issn.1672-7347.2022.210393.

Abstract

We reported a case of oxalate crystal-related acute kidney injury caused by orlistat. The patient was admitted for nephrotic syndrome and acute kidney injury. The pathomorphological assessment of renal biopsy showed intratubular oxalate crystals. The patient reported that she had taken orlistat regularly to loss weight for more than a year. This patient had a habit of drinking vegetable soup and strong herbal tea daily. Orlistat, an intestinal lipase inhibitor, may cause secondary hyperoxaluria, that is, intestinal hyperoxaluria. Dietary habits could be a common precipitating factor for orlistat-relevant hyperoxaluria. It was comprehensively considered to be oxalate crystal-related acute renal injury, and the patient's renal function recovered gradually after drug withdrawal. Clinicians should pay attention to screening drug-related acute kidney injury including orlistat when observing patients with unexplained acute kidney injury, and renal biopsy should be performed if necessary. It is also important to warn people who take the orlistat for weight loss about the side effects of this drug so as to adjust the eating habits.

摘要

我们报告了一例由奥利司他引起的草酸盐晶体相关急性肾损伤。该患者因肾病综合征和急性肾损伤入院。肾活检的病理形态学评估显示肾小管内有草酸盐晶体。患者报告称,她为了减肥,已经有规律地服用奥利司他一年多了。该患者有每天喝蔬菜汤和浓茶的习惯。奥利司他是一种肠道脂肪酶抑制剂,可能导致继发性高草酸尿症,即肠道高草酸尿症。饮食习惯可能是导致奥利司他相关高草酸尿症的常见诱发因素。综合考虑为草酸盐晶体相关急性肾损伤,患者停药后肾功能逐渐恢复。临床医生在观察不明原因急性肾损伤的患者时,应注意筛查包括奥利司他在内的药物相关性急性肾损伤,如果需要,应进行肾活检。此外,还应告诫服用奥利司他减肥的人注意该药物的副作用,以便调整饮食习惯。

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本文引用的文献

1
Pathophysiology and Treatment of Enteric Hyperoxaluria.肠源性高草酸尿症的病理生理学和治疗。
Clin J Am Soc Nephrol. 2021 Mar 8;16(3):487-495. doi: 10.2215/CJN.08000520. Epub 2020 Sep 8.
2
When the Cause Is Not Crystal Clear.
N Engl J Med. 2020 Jan 2;382(1):74-78. doi: 10.1056/NEJMcps1809996.
4
Acute oxalate nephropathy associated with orlistat.与奥利司他相关的急性草酸盐肾病
J Nephropathol. 2016 Apr;5(2):79-83. doi: 10.15171/jnp.2016.14. Epub 2016 Mar 29.
5
The management of patients with enteric hyperoxaluria.肠源性高草酸尿症患者的管理
Urolithiasis. 2016 Feb;44(1):33-43. doi: 10.1007/s00240-015-0846-5. Epub 2015 Dec 8.
7
Enteric hyperoxaluria: an important cause of end-stage kidney disease.肠道高草酸尿症:终末期肾病的一个重要原因。
Nephrol Dial Transplant. 2016 Mar;31(3):375-82. doi: 10.1093/ndt/gfv005. Epub 2015 Feb 20.

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