Renal Toxicity of Rosuvastatin: A Case Report

This is a report of a 64-year-old man who developed acute kidney injury (AKI) associated with high-dose rosuvastatin. He had been treated with statins for several years due to coronary artery disease, hypertension, and hyperlipidemia. He had initially been treated with simvastatin, though it was changed to rosuvastatin for stronger effects on cholesterol and cardiovascular risk reduction. About 12 months after getting rosuvastatin 40 mg per day, AKI was detected. Though other factors were likely contributing, the AKI appeared to be nephrotoxic in nature. There were two medications on his list, rosuvastatin and pantoprazole, which plausibly could cause reduced kidney function, and we discussed a trial of medication withdrawal. He had severe esophageal disease, which was at risk of a flare with coming off the pantoprazole, so we elected to stop rosuvastatin first. After stopping rosuvastatin, the kidney function returned to baseline, and the abnormal urine testing resolved.