Renal failure in a patient with chronic lymphocytic leukaemia treated with fludarabine.

The case history of a man with refractory chronic lymphocytic leukaemia who developed acute renal failure following treatment with fludarabine is presented. A renal biopsy specimen showed features of mesangiocapillary glomerulonephritis, a rare occurrence in chronic lymphocytic leukaemia. The rapid cytocidal action of fludarabine may result in the development of renal glomerular lesions when used to treat a well differentiated B cell malignancy.