title: Ischemic Acute Tubular Necrosis due to Diltiazem Overdose.
abstract: Diltiazem overdose has a high mortality rate due to cardiotoxicity associated with bradycardia and hypotension. A previous article reported that this type of overdose can cause acute tubular necrosis, which was not pathologically, but rather clinically, diagnosed. We herein report the case of a 55-year-old man who sustained nonoliguric acute kidney injury after taking 60 diltiazem tablets. A kidney biopsy performed six days after admission showed ischemic, not toxic, acute tubular necrosis. The patient's kidney function improved spontaneously. In this case report, we clarify the cause of renal impairment caused by diltiazem overdose pathologically. Physicians should therefore consider ischemic acute tubular necrosis as a cause of kidney injury in patients with diltiazem overdose.
authors.affiliation: Department of Nephrology, Chubu-Rosai Hospital, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ryuge
authors.forename: Hideaki
authors.initials: H
authors.lastname: Shimizu
authors.forename: Yukako
authors.initials: Y
authors.lastname: Ohyama
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nomura
authors.forename: Shoichi
authors.initials: S
authors.lastname: Maruyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kitamura
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Fujita
mesh_terms: D001706:Biopsy; D002121:Calcium Channel Blockers / Q000009:adverse effects*; D004110:Diltiazem / Q000009:adverse effects*; D062787:Drug Overdose / Q000150:complications*; D006801:Humans; D007668:Kidney / Q000473:pathology; D007683:Kidney Tubular Necrosis, Acute / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008875:Middle Aged
chemical_list: D002121:Calcium Channel Blockers; D004110:Diltiazem