Related Experiment Video
Updated: Jul 6, 2026
09:02
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Acute renal failure during ATRA treatment
Nese Yarali1, Betül Tavil, Abdurrahman Kara
1Dr. Sami Ulus Children's Hospital, Ankara, Turkey. neseyarali@yahoo.com
Pediatric Hematology and Oncology
|March 26, 2008
Summary
All-trans-retinoic acid (ATRA) treats leukemia but can cause side effects. Concurrent use of fluconazole with ATRA in an acute promyelocytic leukemia patient led to acute renal failure.
Area of Science:
- Oncology
- Pharmacology
- Nephrology
Background:
- All-trans-retinoic acid (ATRA) is a standard treatment for acute promyelocytic leukemia (APL).
- While generally well-tolerated, ATRA can cause severe side effects like retinoic acid syndrome.
- Fluconazole, a triazole derivative, inhibits cytochrome P-450 enzymes, potentially increasing ATRA plasma levels.
Observation:
- A case study involved an acute promyelocytic leukemia patient undergoing ATRA treatment.
- The patient was concurrently administered fluconazole during the ATRA therapy.
Findings:
- The patient developed acute renal failure.
- This adverse event occurred during the combined administration of ATRA and fluconazole.
Implications:
- Concurrent use of fluconazole with ATRA may increase the risk of severe adverse events, including acute kidney injury.
- Clinicians should carefully monitor patients receiving combined ATRA and fluconazole therapy.
- Further research is warranted to elucidate the pharmacokinetic and pharmacodynamic interactions between ATRA and fluconazole.
Related Concept Videos
01:29Acute Kidney Injury II: Pathophysiology
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
01:27Dialysis
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
01:22Acute Kidney Injury I: Introduction
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
01:11Renal Failure: Dose Adjustments
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:20Acute Kidney Injury V: Interprofessional Care
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...