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Cimetidine-induced acute interstitial nephritis

J M Pitone, J J Santoro, R J Biondi

    The American Journal of Gastroenterology
    |March 1, 1982
    PubMed
    Summary

    Cimetidine can cause acute interstitial nephritis, a kidney condition. Rechallenging patients with cimetidine confirmed its role in causing kidney dysfunction and altered serum creatinine levels.

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    Area of Science:

    • Nephrology
    • Pharmacology
    • Internal Medicine

    Background:

    • Cimetidine use is associated with elevated serum creatinine levels.
    • The mechanism was previously attributed to altered renal handling of creatinine.
    • Acute interstitial nephritis (AIN) has been recently reported in patients taking cimetidine.

    Observation:

    • A case study detailing AIN caused by routine cimetidine doses is presented.
    • Review indicates up to 60% of cimetidine users may experience serum creatinine changes.
    • Previous studies lacked detailed urinary protein and sediment analysis.

    Findings:

    • The presented case involved moderate to severe renal insufficiency with AIN.
    • Rechallenging the patient with cimetidine promptly restored clinical signs and symptoms.

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  • Rechallenge also normalized serum creatinine and urinary sediment characteristics.

    • Implications:

    • This study provides definitive proof of cimetidine-induced AIN through drug rechallenge.
    • Highlights the importance of considering cimetidine as a cause of AIN.
    • Suggests routine monitoring of renal function and urinary parameters in patients on cimetidine.