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[Early renal failure caused by mesalazine]
1II. interní klinika LF a FN, Olomouc.
Vnitrni Lekarstvi
|May 10, 2001
Summary
Mesalazine can cause rapid kidney damage in ulcerative colitis patients, even with early asymptomatic renal insufficiency. Prompt drug discontinuation led to swift recovery of kidney function.
Area of Science:
- Nephrology
- Gastroenterology
- Pharmacology
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Mesalazine (5-aminosalicylic acid) is a common treatment for UC.
- Renal adverse events from mesalazine are rare but documented.
Observation:
- A young patient with UC presented with asymptomatic renal insufficiency.
- The patient was treated with high-dose mesalazine.
- Renal function rapidly deteriorated shortly after mesalazine initiation.
Findings:
- Serum urea and creatinine levels became pathologically elevated within 15-27 days of mesalazine administration.
- Urinalysis and renal scintigraphy confirmed significant renal affection.
- Discontinuation of mesalazine resulted in rapid restoration of renal function.
Implications:
- This case highlights the potential for rapid onset of mesalazine-induced nephrotoxicity.
- Clinicians should monitor renal function closely in UC patients treated with mesalazine, especially at high doses.
- Early recognition and drug withdrawal are crucial for favorable renal outcomes.