American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Samy, I. McFarlane
Open Access
Journal Browser
Go
American Journal of Medical Case Reports. 2021, 9(12), 725-729
DOI: 10.12691/ajmcr-9-12-17
Open AccessCase Report

Dapagliflozin Induced Acute Tubulo-Interstitial Nephritis: A Case Report and Literature Review

Nida Saleem1, , Saima Bashir1, Syed Nayer Mahmud1 and Muhammad Haneef1

1Nephrology Department, Shifa International Hospital, Islamabad, 00000, Pakistan

Pub. Date: October 09, 2021

Cite this paper:
Nida Saleem, Saima Bashir, Syed Nayer Mahmud and Muhammad Haneef. Dapagliflozin Induced Acute Tubulo-Interstitial Nephritis: A Case Report and Literature Review. American Journal of Medical Case Reports. 2021; 9(12):725-729. doi: 10.12691/ajmcr-9-12-17

Abstract

We report a case of an elderly male patient, who presented with acute kidney injury on background of diabetic nephropathy, secondary to dapagliflozin induced acute tubulo-interstitial nephritis requiring hemodialysis sessions. Histopathological findings are consistent with moderate tubulo-interstitial inflammation with mixed lymphocytic and eosinophilic inflammatory deposits. The patient responded well to cessation of causative medication and upon initiation of high dose steroids. The direct cause and effect relationship between dapagliflozin initiation and development of acute tubulo-interstitial nephritis is indicative of dapagliflozin being responsible for marked renal deterioration, as seen in this patient.

Keywords:
Acute interstitial nephritis (AIN) Diabetes dapagliflozin SGLT2 inhibitors acute kidney injury (AKI)

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Avogaro A, Giaccari A, Fioretto P, et al. A consensus statement for the clinical use of the renal sodium-glucose co-transporter-2 inhibitor dapagliflozin in patients with type 2 diabetes mellitus. Expert Rev Clin Pharmacol. 2017; 10(7): 763-72.
 
[2]  Fioretto P, Avogaro AJEoop. Dapagliflozin: potential beneficial effects in the prevention and treatment of renal and cardiovascular complications in patients with type 2 diabetes. 2017; 18(5): 517-27.
 
[3]  Aschenbrenner DS. Stronger Warning for Two Diabetes Drugs. Am J Nurs. 2016; 116(10): 26.
 
[4]  Cahn A, Melzer-Cohen C, Pollack R, Chodick G, Shalev VJD, Obesity, Metabolism. Acute renal outcomes with sodium-glucose co-transporter-2 inhibitors: Real-world data analysis. 2019; 21(2): 340-8.
 
[5]  Gilbert RE, Thorpe KEJD, Obesity, Metabolism. Acute kidney injury with sodium-glucose co-transporter-2 inhibitors: A meta-analysis of cardiovascular outcome trials. 2019; 21(8): 1996-2000.
 
[6]  Phadke G, Kaushal A, Tolan DR, et al. Osmotic Nephrosis and Acute Kidney Injury Associated With SGLT2 Inhibitor Use: A Case Report. Am J Kidney Dis. 2020; 76(1): 144-7.
 
[7]  Pleros C, Stamataki E, Papadaki A, et al. Dapagliflozin as a cause of acute tubular necrosis with heavy consequences: a case report. 2018; 7(1): 17-20.
 
[8]  Hahn K, Ejaz AA, Kanbay M, Lanaspa MA, Johnson RJJNRN. Acute kidney injury from SGLT2 inhibitors: potential mechanisms. 2016; 12(12): 711-2.
 
[9]  Heyman SN, Khamaisi M, Rosen S, Rosenberger C, Abassi ZJDC. Potential hypoxic renal injury in patients with diabetes on SGLT2 inhibitors: caution regarding concomitant use of NSAIDs and iodinated contrast media. 2017; 40(4): e40-e1.
 
[10]  Iskander C, Cherney DZ, Clemens KK, et al. Use of sodium–glucose cotransporter-2 inhibitors and risk of acute kidney injury in older adults with diabetes: a population-based cohort study. 2020; 192(14): E351-E60.