orlistat and Acute-Kidney-Injury

We reported a case of oxalate crystal-related acute kidney injury caused by orlistat. The patient was admitted for nephrotic syndrome and acute kidney injury. The pathomorphological assessment of renal biopsy showed intratubular oxalate crystals. The patient reported that she had taken orlistat regularly to loss weight for more than a year. This patient had a habit of drinking vegetable soup and strong herbal tea daily. Orlistat, an intestinal lipase inhibitor, may cause secondary hyperoxaluria, that is, intestinal hyperoxaluria. Dietary habits could be a common precipitating factor for orlistat-relevant hyperoxaluria. It was comprehensively considered to be oxalate crystal-related acute renal injury, and the patient's renal function recovered gradually after drug withdrawal. Clinicians should pay attention to screening drug-related acute kidney injury including orlistat when observing patients with unexplained acute kidney injury, and renal biopsy should be performed if necessary. It is also important to warn people who take the orlistat for weight loss about the side effects of this drug so as to adjust the eating habits.. 报告1例奥利司他致草酸盐结晶相关急性肾损伤病例，该患者因肾病综合征、急性肾损伤入院，肾活检病理检查发现肾小管内草酸盐结晶。患者自诉因减肥而规律服用奥利司他1年余，平日喜饮蔬菜汤和浓凉茶，奥利司他作为肠道脂肪酶抑制剂可能导致继发性高草酸尿症，即肠源性高草酸尿症；饮食习惯是奥利司他致高草酸尿症的共同促发因素。本例患者停药后肾功能有所恢复。临床医生在处理不明原因急性肾损伤患者时应注意排查包括奥利司他在内的药物相关急性肾损伤，必要时可行肾活检。此外，服用该药的减肥人群应注意药物的不良反应，及时调整饮食习惯。.

Topics: Acute Kidney Injury; Female; Humans; Hyperoxaluria; Orlistat; Oxalates; Vegetables

Obesity is an emerging risk factor for chronic kidney disease (CKD) in the developed world. Orlistat, an intestinal lipase inhibitor, used in the treatment of obesity is available as an over-the-counter medication across the European union and in many countries worldwide. It is associated with acute kidney injury (AKI). We present three adults, followed up from 1 to 6 years, who developed de novo or worsening renal impairment while on orlistat. Stopping the drug halted progression, but did not reverse the degree of renal impairment at presentation.

Topics: Acute Kidney Injury; Aged; Anti-Obesity Agents; Diabetes Mellitus, Type 2; Disease Progression; Essential Hypertension; Female; Humans; Hypertension; Lactones; Lipase; Male; Middle Aged; Obesity; Orlistat; Prognosis; Risk Factors

Topics: Acute Kidney Injury; Anti-Obesity Agents; Humans; Lactones; Orlistat

Topics: Acute Kidney Injury; Aged; Anti-Obesity Agents; Female; Humans; Lactones; Male; Middle Aged; Orlistat

We report an unusual complication of orlistat, a gastrointestinal and pancreatic lipase inhibitor used in the treatment of obesity. A 66-year-old man with history of Type 2 diabetes and obesity presented to our hospital with recurrent episodes of hypoglycemia over 2 weeks. His medications included twice daily biphasic insulin and 3 months previously he was prescribed orlistat as treatment for his obesity. On admission he was in acute renal failure with a creatinine concentration of 405 micromol/l. His renal function 4 months previously was normal. Urinalysis revealed neither blood nor protein, but microscopy of his urine revealed moderate amounts of crystals. A renal biopsy revealed normal glomeruli, but there were features of acute tubular necrosis associated with oxalate crystal deposition. Over the next few days his renal function declined and needed hemodialysis. 3 weeks after his admission he continued to require hemodialysis and he unexpectedly had a cardiac arrest and died. Our patient had acute tubular necrosis secondary to orlistat-induced acute oxalate nephropathy. The identification of high risk patients treated with orlistat and regular monitoring of their renal function might reduce the risk of renal failure due to acute oxalate nephropathy.

Topics: Acute Kidney Injury; Aged; Anti-Obesity Agents; Calcium Oxalate; Diabetes Mellitus, Type 2; Fatal Outcome; Humans; Lactones; Male; Necrosis; Obesity; Orlistat

Topics: Acute Kidney Injury; Anti-Obesity Agents; Biopsy; Disease Progression; Female; Follow-Up Studies; Glucocorticoids; Humans; Kidney; Lactones; Lipase; Middle Aged; Obesity; Orlistat; Ultrasonography

Topics: Acute Kidney Injury; Anti-Obesity Agents; Biopsy; Cohort Studies; Disease Progression; Follow-Up Studies; Glucocorticoids; Humans; Kidney; Lactones; Lipase; Obesity; Orlistat; Treatment Outcome; Ultrasonography