title: Acute renal failure when exenatide is co-administered with diuretics and angiotensin II blockers.
abstract: Case (description) the patient is a 20 years old male smoker, who was diagnosed with type 2 diabetes mellitus in 2006. Due to the inadequate response to the previously established treatment, the pharmacotherapy was modified by introducing exenatide (up to 10 μg, twice daily) instead of insulin glargine, but maintaining the treatment with the diuretic and angiotensin II receptor antagonist drugs. Two months later, the patient exhibited a very important intolerance to exenatide (continuous nausea, vomiting, and dehydration), finally leading to ischemic acute renal failure. When the angiotensin II receptor antagonist and exenatide were suspended, a very rapid recovery of renal function was observed. Conclusion ischemic acute renal failure is supposed to be the consequence of the extracellular volume contraction caused by exenatide (the result of continuous nausea and vomiting). This adverse effect could be caused by the co-administration of diuretics and angiotensin II receptor antagonists.
authors.affiliation: Diabetes Unit, Reina Sofía University Hospital, 30003, Murcia, Spain. lablilly@gmail.com
authors.forename: Alfonso
authors.initials: A
authors.lastname: López-Ruiz
authors.forename: Cristina
authors.initials: C
authors.lastname: del Peso-Gilsanz
authors.forename: Amparo
authors.initials: A
authors.lastname: Meoro-Avilés
authors.forename: José
authors.initials: J
authors.lastname: Soriano-Palao
authors.forename: Alberto
authors.initials: A
authors.lastname: Andreu
authors.forename: Juan
authors.initials: J
authors.lastname: Cabezuelo
authors.forename: José L
authors.initials: JL
authors.lastname: Arias
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D057911:Angiotensin Receptor Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D004232:Diuretics / Q000009:adverse effects* / Q000627:therapeutic use; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D000077270:Exenatide; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D010455:Peptides / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D014688:Venoms / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D057911:Angiotensin Receptor Antagonists; D004232:Diuretics; D007004:Hypoglycemic Agents; D010455:Peptides; D014688:Venoms; D000077270:Exenatide