A liver transplant patient developed renal injury on tacrolimus and experienced worsening renal function and rhabdomyolysis after switching to sirolimus: a case report
Abstract Renal impairment and rhabdomyolysis are rare in transplant patients receiving sirolimus. We report the case of a 54-year-old male who underwent liver transplantation and was initially treated with tacrolimus, mycophenolate mofetil, and glucocorticoids for immunosuppression. After the develo...
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| Format: | Article |
| Language: | English |
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BMC
2024-12-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-024-03874-7 |
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| author | Chang Gao Zhi-Yu Chen Liang Ma Shen-Ju Gou |
| author_facet | Chang Gao Zhi-Yu Chen Liang Ma Shen-Ju Gou |
| author_sort | Chang Gao |
| collection | DOAJ |
| description | Abstract Renal impairment and rhabdomyolysis are rare in transplant patients receiving sirolimus. We report the case of a 54-year-old male who underwent liver transplantation and was initially treated with tacrolimus, mycophenolate mofetil, and glucocorticoids for immunosuppression. After the development of renal dysfunction, tacrolimus was replaced with sirolimus. However, one month after taking sirolimus, the patient’s renal function continued to deteriorate, and rhabdomyolysis developed one and a half months later. Serum analysis indicated high sirolimus concentration, whereas renal histopathology revealed acute tubular injury and interstitial arteriopathy. After reducing the dosage of sirolimus, the patient’s creatine kinase levels returned to normal, and renal function improved. Two years after discharge, the patient’s renal function had recovered. This case highlights the importance of monitoring sirolimus blood concentrations in clinical practice, because elevated drug concentrations can lead to renal dysfunction and rhabdomyolysis as adverse reactions. Further investigations into the pathogenic mechanisms of sirolimus-induced renal dysfunction and rhabdomyolysis may contribute to clinical practice. |
| format | Article |
| id | doaj-art-9115ae3981ac4abe9c1dc58d88a8ef4e |
| institution | Kabale University |
| issn | 1471-2369 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj-art-9115ae3981ac4abe9c1dc58d88a8ef4e2024-12-08T12:21:37ZengBMCBMC Nephrology1471-23692024-12-012511810.1186/s12882-024-03874-7A liver transplant patient developed renal injury on tacrolimus and experienced worsening renal function and rhabdomyolysis after switching to sirolimus: a case reportChang Gao0Zhi-Yu Chen1Liang Ma2Shen-Ju Gou3Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan UniversityDepartment of Nephrology, Kidney Research Institute, West China Hospital of Sichuan UniversityDepartment of Nephrology, Kidney Research Institute, West China Hospital of Sichuan UniversityDepartment of Nephrology, Kidney Research Institute, West China Hospital of Sichuan UniversityAbstract Renal impairment and rhabdomyolysis are rare in transplant patients receiving sirolimus. We report the case of a 54-year-old male who underwent liver transplantation and was initially treated with tacrolimus, mycophenolate mofetil, and glucocorticoids for immunosuppression. After the development of renal dysfunction, tacrolimus was replaced with sirolimus. However, one month after taking sirolimus, the patient’s renal function continued to deteriorate, and rhabdomyolysis developed one and a half months later. Serum analysis indicated high sirolimus concentration, whereas renal histopathology revealed acute tubular injury and interstitial arteriopathy. After reducing the dosage of sirolimus, the patient’s creatine kinase levels returned to normal, and renal function improved. Two years after discharge, the patient’s renal function had recovered. This case highlights the importance of monitoring sirolimus blood concentrations in clinical practice, because elevated drug concentrations can lead to renal dysfunction and rhabdomyolysis as adverse reactions. Further investigations into the pathogenic mechanisms of sirolimus-induced renal dysfunction and rhabdomyolysis may contribute to clinical practice.https://doi.org/10.1186/s12882-024-03874-7SirolimusLiver transplantationRhabdomyolysisRenal dysfunction |
| spellingShingle | Chang Gao Zhi-Yu Chen Liang Ma Shen-Ju Gou A liver transplant patient developed renal injury on tacrolimus and experienced worsening renal function and rhabdomyolysis after switching to sirolimus: a case report BMC Nephrology Sirolimus Liver transplantation Rhabdomyolysis Renal dysfunction |
| title | A liver transplant patient developed renal injury on tacrolimus and experienced worsening renal function and rhabdomyolysis after switching to sirolimus: a case report |
| title_full | A liver transplant patient developed renal injury on tacrolimus and experienced worsening renal function and rhabdomyolysis after switching to sirolimus: a case report |
| title_fullStr | A liver transplant patient developed renal injury on tacrolimus and experienced worsening renal function and rhabdomyolysis after switching to sirolimus: a case report |
| title_full_unstemmed | A liver transplant patient developed renal injury on tacrolimus and experienced worsening renal function and rhabdomyolysis after switching to sirolimus: a case report |
| title_short | A liver transplant patient developed renal injury on tacrolimus and experienced worsening renal function and rhabdomyolysis after switching to sirolimus: a case report |
| title_sort | liver transplant patient developed renal injury on tacrolimus and experienced worsening renal function and rhabdomyolysis after switching to sirolimus a case report |
| topic | Sirolimus Liver transplantation Rhabdomyolysis Renal dysfunction |
| url | https://doi.org/10.1186/s12882-024-03874-7 |
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