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Case Reports
. 2023 Mar 28;24(1):76.
doi: 10.1186/s12882-023-03116-2.

Biopsy-proven first dose of oxaliplatin-induced acute tubular necrosis leading to end-stage renal failure: a case report

Yu Soma  1 , Taiichi Kawabe  2 , Daiyu Kitaji  3 , Kaoru Hoshino  3 , Sumire Sunohara  3 , Takehisa Iwano  3 , Naomi Kawano  4
Affiliations
Case Reports

Biopsy-proven first dose of oxaliplatin-induced acute tubular necrosis leading to end-stage renal failure: a case report

Yu Soma et al. BMC Nephrol. .

Abstract

Background: Oxaliplatin is an anticancer therapy for pancreatic, gastric, and colorectal cancers. It is also used in patients with carcinomas of unknown primary sites. Oxaliplatin is associated with less frequent renal dysfunction than other conventional platinum-based drugs such as cisplatin. Albeit, there have been several reports of acute kidney injury with frequent use. In all cases, renal dysfunction was temporary and did not require maintenance dialysis. There have been no previous reports of irreversible renal dysfunction after a single dose of oxaliplatin.

Case presentation: Previous reports of oxaliplatin-induced renal injury occurred after patients received multiples doses. In this study, a 75-year-old male with unknown primary cancer and underlying chronic kidney disease developed acute renal failure after receiving the first dose of oxaliplatin. Suspected of having drug-induced renal failure through an immunological mechanism, the patient was treated with steroids; however, treatment was ineffective. Renal biopsy ruled out interstitial nephritis and revealed acute tubular necrosis. Renal failure was irreversible, and the patient subsequently required maintenance hemodialysis.

Conclusions: We provide the first report of pathology-confirmed acute tubular necrosis after the first dose of oxaliplatin which led to irreversible renal dysfunction and maintenance dialysis.

Keywords: Acute kidney injury; Acute tubular injury; Maintenance dialysis; Oxaliplatin.

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Conflict of interest statement

The authors have declared that no conflict of interest exists.

Figures

Fig. 1
Fig. 1
Renal biopsy. (a, b) Hematoxylin and eosin staining, x 400. Five glomeruli showed global sclerosis. The other glomeruli were normal. The tubules showed diffuse degenerative findings, including severe atrophy, obscuration of the print border, and flattening of the epithelium. (c) Periodic acid–Schiff staining, x 400. Lymphocyte infiltration in the interstitium and tubules was unremarkable. (d) Elastica Masson staining, x 400. Interstitial fibrosis in the interstitium and tubules was unremarkable
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