Acute kidney injury following proton pump inhibitor therapy

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Acute kidney injury following proton pump inhibitor therapy U.C. Brewster, M.A. Perazella Kidney International Volume 71, Issue 6, Pages 589-593 (March 2007) DOI: 10.1038/sj.ki.5002038 Copyright © 2007 International Society of Nephrology Terms and Conditions

Figure 1 Light microscopy reveals normal appearing glomerulus (arrow) with diffuse cellular infiltrate in the interstitium (arrowhead) (hematoxylin and eosin stain). Kidney International 2007 71, 589-593DOI: (10.1038/sj.ki.5002038) Copyright © 2007 International Society of Nephrology Terms and Conditions

Figure 2 Light microscopy demonstrates diffuse cellular infiltrate within the interstitium. The infiltrate consists of eosinophils (arrowhead) and lymphocytes. Tubulitis is also present (arrow) (hematoxylin and eosin stain). Kidney International 2007 71, 589-593DOI: (10.1038/sj.ki.5002038) Copyright © 2007 International Society of Nephrology Terms and Conditions

Figure 3 Bar graphs demonstrating the clinical features of methicillin-induced AIN (longitudinal bars), non-methicillin drug-induced AIN (excluding non-steroidal anti-inflammatory drugs) (horizontal bars), and PPI-induced AIN (Geevasinga data, square pattern bars; other PPI cases combined, solid bars). Abbreviations: AIN, acute interstitial nephritis; NSAIDs, non-steroidal anti-inflammatory drugs; PPI, proton pump inhibitor, Hem, hematuria; Pro, proteinuria; RF, renal failure; Pyu, pyuria; Eos, eosinophilia. (Adapted in part from;16 with permission). Kidney International 2007 71, 589-593DOI: (10.1038/sj.ki.5002038) Copyright © 2007 International Society of Nephrology Terms and Conditions

Figure 4 Calculated creatinine clearance of 18 patients with PPI-induced AIN at various time points before, during and after exposure to PPIs. Abbreviations: PPI, proton pump inhibitor. (Adapted from;15 with permission). Kidney International 2007 71, 589-593DOI: (10.1038/sj.ki.5002038) Copyright © 2007 International Society of Nephrology Terms and Conditions