Related Experiment Video
Updated: Feb 6, 2026
Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice
Published on: August 9, 2013
Acute Kidney Injury Following Methimazole Initiation: A Case Report
Abigail Shell1, Joshua W Sullivan1
1Department of Pharmacy, Memphis VA Medical Center, Memphis, TN, USA.
Objective:
Nephritis has been rarely associated with methimazole, primarily in the development of nephrotic syndrome. We describe a case of acute kidney injury without evidence of nephrotic syndrome following methimazole initiation.
Methods:
We present the relevant history, laboratory data, and nuclear medicine data and review relevant documentation from the literature.
Results:
A 72-year-old male recently diagnosed with new-onset atrial fibrillation was found to have suppressed thyroid-stimulating hormone (TSH) levels; elevated free T3, T4, and thyroid-stimulating immunoglobulin (TSI) levels; and a nonnodular thyroid gland with normal iodine uptake. He was diagnosed with Graves' disease and treated with propylthiouracil (PTU) for 5 years. When his poor compliance with PTU was impeding his antithyroid treatment, he was converted to methimazole. Within 1 month following methimazole initiation, his serum creatinine (SCr) had risen to 1.6× baseline in the absence of other contributing nephrotoxins. SCr returned to baseline within 2 weeks of methimazole discontinuation, and the patient was subsequently managed on PTU.
Conclusion:
Acute kidney injury with or without the presence of nephrotic syndrome may occur during treatment with methimazole. Renal function should be closely monitored after the initiation of methimazole to prevent progressive renal dysfunction.
Insights
Methimazole can cause acute kidney injury, even without nephrotic syndrome. Close monitoring of renal function is crucial after starting this medication to prevent kidney damage.
Area of Science:
- Nephrology
- Endocrinology
- Pharmacology
Background:
- Methimazole is a common antithyroid drug used to treat Graves' disease.
- Nephritis is a rare complication of methimazole, typically presenting as nephrotic syndrome.
Observation:
- A 72-year-old male with Graves' disease developed acute kidney injury (AKI) within one month of switching from propylthiouracil to methimazole.
- The patient's renal function normalized after discontinuing methimazole, with no evidence of nephrotic syndrome.
Findings:
- This case highlights methimazole-induced AKI as a potential adverse effect.
- The absence of nephrotic syndrome in this case broadens the spectrum of renal complications associated with methimazole.
Implications:
- Clinicians should consider methimazole as a potential cause of AKI in patients presenting with renal dysfunction.
- Close monitoring of renal function is recommended upon initiation of methimazole therapy to detect and manage potential kidney injury early.
Related Concept Videos
01:22Acute Kidney Injury I: Introduction
01:29Acute Kidney Injury II: Pathophysiology
01:22Acute Kidney Injury VI: Nursing Management
01:20Acute Kidney Injury V: Interprofessional Care
01:29Acute Kidney Injury III: Clinical Manifestations
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention