title: Orlistat-induced oxalate nephropathy may be dose-independent and present as a late manifestation.
abstract: We present the case of a 61-year-old Caucasian male veteran who had been on orlistat (120mg dosing) for four years, and had changed to the over-the-counter (OTC) form, Alli (orlistat 60mg), about three months before presentation. He had been experiencing nausea and vomiting for three weeks prior to evaluation. Laboratory studies revealed a serum creatinine of 6.2 mg/dL--his previous renal function having been normal. An ultrasound-guided renal biopsy was performed, which revealed deposition of calcium oxalate crystals in the renal tubules. Orlistat is a popular weight-loss medication. Orlistat-induced oxalate crystal nephropathy has recently been reported in the literature, resulting from the original, patented version. We report a case with the first such complication from the OTC version, Alli - which is a reduced-dose formulation. Our case report highlights that this complication can occur after several years of use of the medication and is not necessarily dose dependant.
authors.affiliation: Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA.
authors.forename: Neville R
authors.initials: NR
authors.lastname: Dossabhoy
authors.affiliation: Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: McRight
authors.affiliation: Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA.
authors.forename: Bhupinder
authors.initials: B
authors.lastname: Sangha
authors.affiliation: Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Khan
authors.affiliation: Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA.
authors.forename: Cherinet
authors.initials: C
authors.lastname: Adgeh
mesh_terms: D019440:Anti-Obesity Agents / Q000008:administration & dosage / Q000009:adverse effects; D002129:Calcium Oxalate / Q000378:metabolism*; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000378:metabolism; D007783:Lactones / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs; D009765:Obesity / Q000188:drug therapy; D000077403:Orlistat; D013997:Time Factors
chemical_list: D019440:Anti-Obesity Agents; D007783:Lactones; D004366:Nonprescription Drugs; D002129:Calcium Oxalate; D000077403:Orlistat