Acute kidney injury in patients with inactive cytochrome P450 polymorphisms

Nelson Leung, Alfonso Eirin, Maria Irazabal Mira, Daniel E. Maddox, Heidi D. Gunderson, Fernando Custodio Fervenza, Vesna D Garovic

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Medications are a major source of acute kidney injury, especially in critically ill patients. Medication-induced renal injury can occur through a number of mechanisms. We present two cases of acute kidney injury (AKI) where inactive cytochrome P450 (CYP) polymorphism may have played a role. The first patient developed a biopsy-proven allergic interstitial nephritis following urethrotomy. Genetic testing revealed the patient to be heterozygous for an inactivating polymorphism CYP2C9*3 and homozygous for an inactivating polymorphism CYP2D6*4. Patient had received several doses of promethazine, which is metabolized by CYP2D6*4. Another patient developed AKI on several occasions after exposure to lansoprazole and allopurinol. CYP testing revealed the patient to be homozygous for inactivating polymorphism CYP2C19*2, which is responsible for the metabolism of lansoprazole. These are the first two cases of AKI associated with non-functional polymorphisms of cytochrome P450 superfamily. While the exact mechanism has not been worked out, it introduced the possibility of a new source of kidney injury.

Original languageEnglish (US)
Pages (from-to)749-752
Number of pages4
JournalRenal Failure
Volume31
Issue number8
DOIs
StatePublished - 2009

Fingerprint

Acute Kidney Injury
Cytochrome P-450 Enzyme System
Lansoprazole
Cytochrome P-450 CYP2D6
Promethazine
Kidney
Interstitial Nephritis
Allopurinol
Wounds and Injuries
Genetic Testing
Critical Illness
Biopsy

Keywords

  • Acute kidney injury
  • Cytochrome P450
  • Interstitial nephritis

ASJC Scopus subject areas

  • Nephrology
  • Critical Care and Intensive Care Medicine

Cite this

Acute kidney injury in patients with inactive cytochrome P450 polymorphisms. / Leung, Nelson; Eirin, Alfonso; Irazabal Mira, Maria; Maddox, Daniel E.; Gunderson, Heidi D.; Fervenza, Fernando Custodio; Garovic, Vesna D.

In: Renal Failure, Vol. 31, No. 8, 2009, p. 749-752.

Research output: Contribution to journalArticle

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AU - Fervenza, Fernando Custodio

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