Abstract
Acute kidney injury (AKI) is a recognised complication of intravenous pentamidine therapy. A direct nephrotoxic effect leading to acute tubular necrosis has been postulated. We report a case of severe renal allograft dysfunction due to nebulised pentamidine. The patient presented with repeated episodes of AKI without obvious cause and acute tubular necrosis only on renal histology. Nebulised pentamidine was used monthly as prophylaxis for Pneumocystis jirovecii pneumonia, and administration preceded the creatinine rise on each occasion. Graft function stabilised following discontinuation of the drug. This is the first report of nebulized pentamidine-induced reversible nephrotoxicity in a kidney allograft. This diagnosis should be considered in a case of unexplained acute renal allograft dysfunction.
Highlights
Drug-induced nephrotoxicity is a potential cause of acute kidney allogra dysfunction in the early posttransplant period [1]. e most common culpable medications are calcineurin inhibitors [2], as other agents associated with nephrotoxicity are generally avoided in this setting
Nebulized pentamidine is an alternative for those patients who are intolerant of cotrimoxazole
Acute kidney injury (AKI) has been reported as a complication of intravenous pentamidine therapy. ere is a single case report of nebulised pentamidine causing an adverse effect on renal function in native kidneys
Summary
Acute kidney injury (AKI) is a recognised complication of intravenous pentamidine therapy. A direct nephrotoxic effect leading to acute tubular necrosis has been postulated. We report a case of severe renal allogra dysfunction due to nebulised pentamidine. E patient presented with repeated episodes of AKI without obvious cause and acute tubular necrosis only on renal histology. Nebulised pentamidine was used monthly as prophylaxis for Pneumocystis jirovecii pneumonia, and administration preceded the creatinine rise on each occasion. Gra function stabilised following discontinuation of the drug. Is is the rst report of nebulized pentamidine-induced reversible nephrotoxicity in a kidney allogra . Is diagnosis should be considered in a case of unexplained acute renal allogra dysfunction Gra function stabilised following discontinuation of the drug. is is the rst report of nebulized pentamidine-induced reversible nephrotoxicity in a kidney allogra . is diagnosis should be considered in a case of unexplained acute renal allogra dysfunction
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