Life threatening acute kidney injury in a patient of rheumatoid arthritis, is it drug or disease related?
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20222752Keywords:
Nephrotoxicity, Low dose methotrexate, Rheumatoid arthritisAbstract
Even low-dose MTX therapy for treatment of rheumatic diseases is claimed to cause impairment in renal function. We report an insidious and progressive deterioration of renal function of patient with RA on low-dose MTX in a 41-year-old woman. We suggest that patients on low-dose MTX therapy should be periodically monitored for creatinine levels.
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References
Buchbinder R, Hall S, Sambrook PN. Methotrexate therapy in rheumatoid arthritis: a life table review of 587 patients treated in community practice. J Rheumatol. 1993;20(4):639-44.
Bullock J, Rizvi SAA, Saleh AM, Ahmed SS, Do DP, Ansari RA, et al. Rheumatoid arthritis: a brief overview of the treatment. Med Princ Pract. 2018; 27(6):501-7.
John R, Herzenberg AM. Renal toxicity of therapeutic drugs. J Clin. Pathol. 2009;62:505-15.
Howard SC, McCormick J, Pui CH, Buddington RK, Harvey RD. Preventing and managing toxicities of high-dose methotrexate. Oncologist. 2016;21(12): 1471-82.
Widemann BC. Understanding and managing methotrexate nephrotoxicity. Oncologist. 2006;11(6): 694-703.
Kremer JM, Petrillo GF, Hamilton RA. Pharmacokinetics and renal function in patients with rheumatoid arthritis receiving a standard dose of oral weekly methotrexate: association with significant decreases in creatinine clearance and renal clearance of the drug after 6 months of therapy. J Rheumatol. 1995;22:38.
Singh JA, Saag KG, Bridges SL. 2015 American college of rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol. 2016; 68:1-26.
Kremer JM, Petrillo GF, Hamilton RA. Pharmacokinetics and renal function in patients with rheumatoid arthritis receiving a standard dose of oral weekly methotrexate: association with significant decreases in creatinine clearance. J Rheumatol. 1995;22:38.
Bloom EJ, Ignoffo RJ, Cadman E, Reis CA. Delayed clearance of methotrexate associated with antibiotics and antiinflammatory agents. Clin Res. 1986;34(1): 560.
Frenia ML, Long KS. Methotrexate and nonsteroidal antiinflammatory drug interactions. Ann Pharmacother. 1992;26(2):234-7.
Guleria JS, Malaviya AN, Pandey JN, Singh RR. Fatal interaction between methotrexate and naproxen. Lancet. 1986;1:139.
Shea B, Swinden MV, Tanjong Ghogomu E. Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis. Cochrane Database Syst Rev. 2013;(5): CD000951.
