title: Pemetrexed-Induced Nephrogenic Diabetes Insipidus.
abstract: Pemetrexed is an approved antimetabolite agent, now widely used for treating locally advanced or metastatic nonsquamous non-small cell lung cancer. Although no electrolyte abnormalities are described in the prescribing information for this drug, several case reports have noted nephrogenic diabetes insipidus with associated acute kidney injury. We present a case of nephrogenic diabetes insipidus without severely reduced kidney function and propose a mechanism for the isolated finding. Severe hypernatremia can lead to encephalopathy and osmotic demyelination, and our report highlights the importance of careful monitoring of electrolytes and kidney function in patients with lung cancer receiving pemetrexed.
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Palo Alto, CA. Electronic address: efung@stanford.edu.
authors.forename: Enrica
authors.initials: E
authors.lastname: Fung
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Palo Alto, CA.
authors.forename: Shuchi
authors.initials: S
authors.lastname: Anand
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Palo Alto, CA.
authors.forename: Vivek
authors.initials: V
authors.lastname: Bhalla
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D018500:Diabetes Insipidus, Nephrogenic / Q000139:chemically induced*; D006801:Humans; D008297:Male; D000068437:Pemetrexed / Q000009:adverse effects*
chemical_list: D000970:Antineoplastic Agents; D000068437:Pemetrexed
keywords: Nephrogenic diabetes insipidus; adverse drug reaction; drug toxicity; pemetrexed; proton coupled folate transporters