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Clindamycin-induced acute kidney injury: large biopsy case series

Honglang Xie1, Huiping Chen, Yangling Hu

  • 1Research Institute of Nephrology, Jinling Hospital, Nanjing University Clinical School of Medicine, Nanjing, PR China.

American Journal of Nephrology
|August 15, 2013
PubMed
Abstract

Insights

Clindamycin-induced acute kidney injury (AKI) is uncommon but increasing. This study found AKI often presents with gross hematuria and severe tubular dysfunction, but is largely reversible with treatment.

Area of Science:

  • Nephrology
  • Pharmacology
  • Toxicology

Background:

  • Clindamycin-induced acute kidney injury (AKI) is an uncommon but increasingly reported adverse drug reaction.
  • Recent years have seen a rise in documented cases of clindamycin-associated kidney damage.

Purpose of the Study:

  • To investigate the clinical characteristics, renal biopsy findings, and outcomes of patients with clindamycin-induced AKI.
  • To understand the mechanisms and reversibility of kidney injury associated with clindamycin use.

Main Methods:

  • Retrospective analysis of 24 patients diagnosed with clindamycin-induced AKI.
  • Review of patient data including clindamycin dosage, clinical presentation, urine analysis, and renal biopsy results.
  • Assessment of renal function recovery post-treatment and use of clindamycin lymphocyte transformation assay.

Main Results:

  • The majority of patients (23/24) presented with AKI stage 3, often with gross hematuria (15 patients).
  • Renal biopsies confirmed acute interstitial nephritis (AIN) and/or acute tubular necrosis (ATN), linked to tubular toxicity and drug crystals.
  • Severe AKI requiring renal replacement therapy occurred in 87.5% of patients, with significant renal function recovery observed within 2 months post-discharge.

Conclusions:

  • Clindamycin-induced AKI is characterized by severe tubular dysfunction and often gross hematuria.
  • Histopathological findings include AIN and ATN, indicating tubular toxicity as a primary mechanism.
  • Despite severity, clindamycin-induced AKI is largely reversible, highlighting the importance of early diagnosis and management.

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