Semaglutide-Associated Acute Interstitial Nephritis: A Case Report

Area of Science:

• Nephrology
• Endocrinology
• Pharmacology

Background:

• Glucagon-like peptide 1 receptor agonists (GLP-1RAs) are increasingly used for type 2 diabetes and show kidney protective effects.
• Benefits include improved cardiac outcomes, reduced mortality, and decreased macroalbuminuria in patients with chronic kidney disease (CKD).
• Semaglutide, a potent GLP-1RA, is widely prescribed, necessitating a thorough understanding of its adverse effect profile.

Observation:

• A case of acute interstitial nephritis (AIN) requiring hemodialysis was observed.
• The AIN was temporally associated with a dose escalation of semaglutide.
• Notably, the patient had no prior history of chronic kidney disease (CKD).

Findings:

• This represents a unique case of semaglutide-associated AIN in a patient with previously normal kidney function.
• Previous reports of semaglutide-induced kidney injury primarily involved patients with underlying CKD.
• This case expands the known spectrum of serious adverse renal effects associated with GLP-1RAs.

Implications:

• Healthcare providers should be vigilant for acute kidney injury in patients initiating or increasing semaglutide dosage, irrespective of baseline kidney function.
• Early recognition and management of drug-associated AIN are crucial to prevent irreversible kidney damage.
• Further research is warranted to elucidate the mechanisms and incidence of GLP-1RA-induced AIN in diverse patient populations.