EXENATIDE INDUCED ACUTE KIDNEY INJURY
Abstract
Exenatide is an incretin mimetic. It was approved by the federal drug authority in 2005 for the treatment of type-2 diabetes. Since it is a relatively new medicine clinicians have limited experience with regards to its side effects and safety profile. We report a 47 year old lady who presented with exenatide associated acute kidney injury. She had type-2 diabetes for 10 years with mild micro albuminuria and normal renal functions. She was also taking a stable dose of metformin, gliclazide, angiotensin converting enzyme inhibitor and diuretic for over a year and there was no history of any recent use of non-steroid anti-inflammatory medications. One week after starting exenatide, she developed severe vomiting, followed by hypotension. She presented with acute renal insufficiency and severe lactic acidosis and had to be dialyzed on emergency basis. To our knowledge this is probably the first case reported in the local United Arab Emirate (U.A.E) population.Keywords: Exenatide, renal failure, incretin mimetics, complicationReferences
Zinman B, Hoogwerf BJ, Durán García S, Milton DR, Giaconia JM, Kim DD, et al. The effect of adding exenatide to a thiazolidinedione in sub optimally controlled type 2 diabetes: a randomized trial. Ann Intern Med.2007; 146:477–85.
Weise WJ, Sivanandy MS, Block CA, Comi RJ. Exenatide associated ischemic renal failure. Diabetes Care. 2009;32:22–3.
Food and Drug Administration. Safety Alerts for Human Medical Products [updated 2010 Feb5;].Available from www.fda.gov/Safety/MedWatch/Safety Information/Safety AlertsforHumanMedicalProducts/ucm188703.htm
Abuelo JG. Normotensive ischemic acute renal failure. N Engl J Med.2007;357:797–805.
Lopez-Riuz A, del Peso-Gilsanz C, Meoro-Aviles A, Soriano-Palao J, Andreu A, Cabezuelo J,et al.Acute renal failure when exenatide is co-administered with diuretics and angiotensin ii blockers. Pharm World Sci 2010;32(5):559–61
Nandakoban H, Furlong TJ, Flack JR. Acute tubulointerstitial nephritis following treatment with exenatide. Diabet Med 2013;30(1):123–5.
Gutzwiller JP, Tschopp S, Bock A, Zehnder CE, Huber AR, Kreyenbuehl M, et al .Glucagon-Like Peptide 1 Induces Natriuresis in Healthy Subjects and in Insulin-Resistant Obese Men JCEM .2004;89:3055–61
Salpeter SR, Greyber E, Pasternak GA, Salpeter EE: Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus: systematic review and meta-analysis.Arch Intern Med 2003,163:2594–02
Gutzwiller JP, Drewe J, Göke B, Schmidt H, Rohrer B, Lareida J, et al. Glucagon-like peptide-1 promotes satiety and reduces food intake in patients with diabetes mellitus type 2. Am J Physiol 1999;276:1541–4.
Johansen OE, Whitfield R. Exenatide may aggravate moderate diabetic renal impairment: a case report. Br J Clin Pharmacol 2008;66:568–9.
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