Clindamycin-induced acute kidney injury: large biopsy case series.
BACKGROUND
While clindamycin-induced acute kidney injury (AKI) is uncommon, it has occurred more frequently in recent years.


CONCLUSIONS
We investigated 24 patients diagnosed with clindamycin-induced AKI retrospectively. The dosage of clindamycin was 1.0-1.5 g/day. Fifteen patients had episodes of gross hematuria, but fever, skin rash and eosinophilia were rare. Urine analysis revealed mild proteinuria and severe tubular dysfunction. Twenty-three patients were diagnosed with AKI stage 3 upon admission. The clindamycin lymphocyte transformation assay was positive for 63.2% of the patients. Acute interstitial nephritis (AIN) and acute tubular necrosis (ATN) were proven by renal biopsy, and renal insufficiency appeared to result from tubular toxicity and drug crystals. In the majority (87.5%) of the patients, AKI was severe and required renal replacement therapy, but all of their renal function recovered significantly 2 months after discharge. Clindamycin-induced AKI is largely reversible and has episodes of gross hematuria. Renal biopsies confirmed AIN or ATN in these patients.
Research Institute of Nephrology, Jinling Hospital, Nanjing University Clinical School of Medicine, Nanjing, PR China.
Honglang
H
Xie
Huiping
H
Chen
Yangling
Y
Hu
Shutian
S
Xu
Qunpeng
Q
He
Jing
J
Liu
Weixin
W
Hu
Zhihong
Z
Liu
D058186:Acute Kidney Injury / Q000139:chemically induced*; D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001706:Biopsy; D002981:Clindamycin / Q000009:adverse effects*; D005260:Female; D006417:Hematuria / Q000139:chemically induced; D006801:Humans; D007684:Kidney Tubules / Q000187:drug effects; D008214:Lymphocytes / Q000166:cytology; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000139:chemically induced; D009395:Nephritis, Interstitial / Q000139:chemically induced; D011507:Proteinuria / Q000139:chemically induced; D012189:Retrospective Studies; D055815:Young Adult
D000900:Anti-Bacterial Agents; D002981:Clindamycin