Clindamycin-induced Kidney Diseases: A Retrospective Analysis of 50 Patients

Abstract

Objective There are many adverse reactions due to clindamycin, but kidney diseases (acute kidney injury, AKI) are uncommon. However, in recent years, the rate of clindamycin-induced kidney diseases has increased. We analyzed 50 patients with clindamycin-induced kidney diseases retrospectively, and investigated the characteristics of these kidney diseases in order to provide a reference for rational clinical drug use and to reduce drug-induced organ damage. Methods We investigated 50 patients diagnosed with clindamycin-induced kidney diseases retrospectively at the Department of Nephrology, Shandong University Qilu Hospital, from January 2009 to December 2013. The parameters included in our study were age, sex, clinical manifestations, efficacy and prognosis. Results All patients were diagnosed with clindamycin-induced kidney diseases within 48 hours of the application of clindamycin at 1.0-2.0 g/day. The patients included 29 women and 21 men. Most of the enrolled patients were 20-59 years old. Fifty-one patients were diagnosed with AKI stage 3 upon admission. Thirtythree had episodes of gross hematuria, but fever, skin rash and eosinophilia were rare. Urine analysis revealed mild proteinuria and severe tubular dysfunction. In the majority of patients, AKI was severe and required renal replacement therapy, but renal function in all patients had recovered significantly two months after discharge. Conclusion Clindamycin-induced AKI is largely reversible and is associated with episodes of gross hematuria. Clinicians should use clindamycin rationally and reduce the incidence of adverse reactions.

Clindamycin: An Unusual Cause of Acute Kidney Injury

“…All reported patients thus far have been Asian, while our patient was African-American and the first reported case from North America. The most common symptoms on admission in the other 2 studies [10,11] were abdominal discomfort, nausea, and vomiting, similar to what our patient experienced. The median onset of AKI following clindamycin administration in the other 2 studies was between 1 and 4 days.…”

“…We performed a literature search on PubMed database for articles using the following words alone or in combination: clindamycin side effect, AKI due to clindamycin, drug related AKI, acute interstitial nephritis (AIN) due to clindamycin, and acute tubular necrosis (ATN) due to clindamycin. While our search yielded no single case report published, we found 2 retrospective studies from China that described case series of biopsy proven AKI due to clindamycin [10,11]. The study by Wan et al [10] reported 50 patients and the study by Xie et al [11] reported a case series consisting of 24 patients with biopsy proven clindamycin-induced AKI.…”

“…While our search yielded no single case report published, we found 2 retrospective studies from China that described case series of biopsy proven AKI due to clindamycin [10,11]. The study by Wan et al [10] reported 50 patients and the study by Xie et al [11] reported a case series consisting of 24 patients with biopsy proven clindamycin-induced AKI.…”

“…In the retrospective case series described by Wan et al [10] and Xie et al [11] the median patient age was 42.1 years and 41.1 years, respectively. In the study by Wan, females were more likely to develop AKI (29 females versus 21 males) while Xie et al demonstrated opposite results, with men more likely to develop clindamycin-induced AKI (14 males versus 10 females).…”

Nitrite-induced acute kidney injury with secondary hyperparathyroidism

“…Postrenal acute kidney injury is often caused by urinary tract obstruction. [ 7 , 8 ] In many of cases, the decreased effective blood volume and presence of substances harmful to the kidney are the main causes of acute kidney injury in clinical practice.…”