Acute kidney injury: an unusual complication of posaconazole use

Triazole antifungals are useful in the treatment of Aspergillus disease and these drugs have side effects which clinicians should be aware of. Posaconazole is an orally administered second-generation triazole antifungal agent which inhibits lanosterol 14-alpha-demethylase, an enzyme that converts lanosterol to ergosterol, a vital component of the fungal cell membrane. Posaconazole has a favorable side effect profile, is safe and well tolerated when compared to the earlier generation of triazole antifungals. Common side effects of posaconazole include gastrointestinal, hepatobiliary, neurological, and skin and subcutaneous disorders. Renal disorders are classed as an uncommon side effect of posaconazole, occurring in ∼0.1-1% of patients. We describe 2 episodes of acute kidney injury (AKI) in a Caucasian whose Aspergillus lung disease was being treated with posaconazole. Regular monitoring of renal function may be necessary for patients on posaconazole to facilitate early identification of acute kidney injury which is reversible.