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Acute Kidney Injury from Mononuclear Cell-Predominated Interstitial Nephritis After Introduction of a Glucagon-Like

Raweekarn Itsathitpaisarn1, Nattavong Suksawad2, Watsapol Wongwikrom2

  • 1Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

The American Journal of Case Reports
|December 7, 2025
PubMed

Insights

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) can rarely cause interstitial nephritis in diabetic kidney disease (DKD) patients. Discontinuation of the drug led to kidney function recovery, highlighting the need for monitoring.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are crucial in managing diabetic kidney disease (DKD).
  • While generally renoprotective, rare instances of kidney injury associated with GLP-1 RAs have been documented, presenting with varied severity and onset times.

Purpose of the Study:

  • To report a case of interstitial nephritis in a patient with DKD following dulaglutide administration.
  • To emphasize the importance of monitoring for potential adverse renal events associated with GLP-1 RA therapy.

Main Methods:

  • A case report of a 63-year-old woman with stage 3b DKD is presented.
  • The patient developed elevated creatinine levels after initiating dulaglutide, with kidney biopsy confirming interstitial nephritis.
  • Nephrotoxic medications were ceased, and other causes of kidney injury were excluded.

Main Results:

  • The patient experienced a doubling of serum creatinine after dulaglutide initiation.
  • Kidney biopsy revealed active interstitial nephritis and diabetic nephropathy.
  • Discontinuation of dulaglutide resulted in near-complete recovery of kidney function without the need for steroid therapy.

Conclusions:

  • Acute-to-chronic tubulointerstitial nephritis is a rare but possible adverse effect of GLP-1 RAs in DKD patients.
  • Vigilant monitoring is essential during GLP-1 RA initiation or dose adjustment.
  • GLP-1 RAs remain valuable for DKD management, with treatment involving drug cessation and potentially steroids for non-responders.

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