Biomaterial Database

Alogliptin-Induced Minimal Change Nephrotic Syndrome and Interstitial Nephritis. 2019

Hisato Shima, and Takuya Okamoto, and Manabu Tashiro, and Tomoko Inoue, and Chiaki Masaki, and Hiroaki Tada, and Norimichi Takamatsu, and Kazuhiko Kawahara, and Kazuyoshi Okada, and Toshio Doi, and Jun Minakuchi, and Shu Kawashima

Department of Kidney Disease, Kawashima Hospital, Tokushima.

Alogliptin is one of the dipeptidyl peptidase-4 inhibitors used to treat patients with type 2 diabetes. Little is known about the nephrotoxicity associated with alogliptin, such as nephrotic syndrome or interstitial nephritis. We report a biopsy-proven rare case of minimal change nephrotic syndrome and interstitial nephritis induced by alogliptin. A 68-year-old man who had been prescribed alogliptin was hospitalized for nephrotic syndrome. On admission, serum creatinine level was elevated with increased urinary β2-microglobulin and N-acetyl-β-d-glucosaminidase excretion. Kidney biopsy revealed minor glomerular abnormalities and interstitial nephritis, and gallium-67 scintigraphy showed uptake in both kidneys. A drug lymphocyte stimulation test for alogliptin was positive. With discontinuation of alogliptin treatment alone, serum creatinine level normalized in parallel with urine β2-microglobulin and N-acetyl-β-d-glucosaminidase levels. In addition, complete remission of nephrotic syndrome was observed. Drug-induced dual pathology has not been previously reported with alogliptin. In summary, clinicians should keep in mind that alogliptin can induce minimal change nephrotic syndrome and interstitial nephritis.