[Acute renal failure due to drugs in diabetics patients]

Acute renal failure (ARF) in patients with diabetes mellitus is frequent. It is caused by several factors notably drugs. Our retrospective study includes 20 cases of ARF induced by drugs in diabetic patients. Eleven men and 9 women with mean age of 55.2 years (17-71 years) were enrolled in the study. Type 2 diabetes mellitus was found in 18 cases and type 1 in 2 cases. Risk factors found are age more than 70 years in 17 cases, pre-existent renal failure in 17 cases, dehydratation in 6 cases, and drug association in 9 cases. In our study diuretics used solely or in association with other drugs were found to be the essential cause of ARF. ACE was noted in 5 cases, gentamycin in 2 cases, non-steroidal antiinflammatory drugs in 1 case, colimycin in 1 case and radiographic contrast media in 4 cases. Symptoms of hypersensitivity are fever in 3 cases, itchiness in 2 case, hepatic dysfunction in 7 case, and hypereosinophilia in 3 cases. Oliguria was observed in 11 patients. Eight patients were dialyzed. Renal function recovery is total in 9 case and partial in 9 others. Two patients having oliguria died.

Diuretics are the first cause of drug-induced ARF in diabetic patients. This ARF worsens the renal prognosis for these patients. Oliguria is high risk of mortality.