title: Reversible acute kidney injury requiring haemodialysis five days after starting dronedarone in a stable 71-year-old man at risk of cardiovascular polypharmacy.
abstract: We present a case of severe acute kidney injury (AKI) occurring shortly after the initiation of dronedarone therapy, which we suspect was the result of an adverse drug reaction. The mechanism of AKI cannot be definitively determined. The most probable mechanism however involves dehydration secondary to diarrhoea, and medications causing hypotension, both precipitating AKI, further exacerbated by reduced excretion of medications reducing tissue perfusion. This case adds to the growing number of reports submitted to pharmacovigilance authorities regarding the association between dronedarone and AKI. It serves as a reminder of the risks of cardiovascular polypharmacy likely to be prevalent in patients considered for dronedarone (which causes diarrhoea as a common side-effect).
authors.affiliation: St James’s University Hospital, Leeds, UK.
authors.forename: C
authors.initials: C
authors.lastname: Young
authors.forename: M
authors.initials: M
authors.lastname: Maruthappu
authors.forename: R P
authors.initials: RP
authors.lastname: Wayne
authors.forename: L
authors.initials: L
authors.lastname: Leaver
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000628:therapy; D000368:Aged; D000638:Amiodarone / Q000009:adverse effects / Q000031:analogs & derivatives*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy*; D003681:Dehydration / Q000139:chemically induced; D003967:Diarrhea / Q000139:chemically induced; D000077764:Dronedarone; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008297:Male; D060735:Pharmacovigilance; D019338:Polypharmacy; D006435:Renal Dialysis
chemical_list: D000889:Anti-Arrhythmia Agents; D000959:Antihypertensive Agents; D000077764:Dronedarone; D000638:Amiodarone
keywords: Dronedarone; acute kidney injury; adverse reaction; case report; pharmacovigilance