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Relapsing acute kidney injury associated with pegfilgrastim
Swati Arora1, Arpit Bhargava, Katherine Jasnosz
1Division of Nephrology and Hypertension, Department of Medicine, Temple University School of Medicine, Pittsburgh, Pa., USA.
Case Reports in Nephrology and Urology
|January 18, 2013
Summary
Pegfilgrastim can cause severe acute kidney injury (AKI) and glomerulonephritis (GN). Routine monitoring of kidney function and urinalysis is crucial for early detection and management of this complication.
Area of Science:
- Nephrology
- Oncology
- Pharmacology
Background:
- Pegfilgrastim is a growth factor used in cancer therapy to stimulate white blood cell production.
- Acute kidney injury (AKI) is a serious complication that can occur during cancer treatment.
- Glomerulonephritis (GN) is a kidney disease affecting the glomeruli.
Observation:
- A patient with breast cancer developed severe AKI after receiving pegfilgrastim.
- Kidney biopsy revealed mesangioproliferative GN and tubular necrosis.
- Recurrent AKI occurred upon re-administration of pegfilgrastim, resolving after its discontinuation.
Findings:
- Pegfilgrastim was identified as the likely cause of GN and severe AKI.
- The patient's kidney function improved significantly after stopping pegfilgrastim.
- Chemotherapy cycles without pegfilgrastim did not result in further AKI episodes.
Implications:
- Pegfilgrastim is a potential cause of glomerulonephritis and severe AKI.
- Early detection of AKI associated with pegfilgrastim is vital.
- Routine renal function and urinalysis monitoring are recommended for patients receiving pegfilgrastim.
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