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Updated: Apr 15, 2026

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Published on: March 29, 2024
Renal phospholipidosis possibly induced by ranolazine
Christoph Scheurle1, Maximilian Dämmrich2, Jan U Becker2
1Medizinische Abteilung , St. Franziskus-Hospital , Münster , Germany.
Ranolazine, an anti-anginal drug, may cause phospholipidosis (PL), a kidney storage disorder. This case highlights ranolazine as a potential trigger for drug-induced PL, necessitating its consideration in differential diagnoses.
Area of Science:
- Nephrology
- Cardiology
- Toxicology
Background:
- Acutely decompensated heart failure in a 76-year-old male led to acute-on-chronic kidney failure.
- Kidney biopsy revealed secondary focal-segmental glomerulosclerosis, minimal amyloidosis, and podocyte zebra bodies, suggesting phospholipidosis (PL).
Purpose of the Study:
- To investigate the potential cause of drug-induced phospholipidosis (PL) in a patient with heart failure and kidney injury.
- To evaluate ranolazine as a potential iatrogenic trigger for PL.
Main Methods:
- Histological analysis of kidney biopsy, including electron microscopy to identify zebra bodies.
- Review of patient's medication history, focusing on cationic amphiphilic drugs.
Main Results:
- Kidney biopsy showed histological features consistent with phospholipidosis (PL), characterized by podocyte zebra bodies.
- The patient had a history of ranolazine use, an anti-anginal drug not previously linked to PL.
Conclusions:
- Ranolazine is implicated as a potential causative agent in drug-induced phospholipidosis (PL).
- Ranolazine should be considered in the differential diagnosis of phospholipidosis (PL) in patients with relevant clinical history.
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