POS-009 CAPTOPRIL-INDUCED ACUTE INTERSTITIAL NEPHRITIS: A RARE ASSOCIATION

ABSTRACT

Introduction: Acute interstitial nephritis (AIN) is an important reversible cause of acute kidney injury (AKI). Its prevalence is about 6-8% in histologically proven AKI.Early diagnosis of drug-induced AKI is vital because the discontinuation of the causal treatment facilitates recovery of the renal function. Methods: We report a case of captopril-induced AIN. Results: We report the case of a 82-year-old woman with a history of untreated hypertension. She was admittedin our department for AKI. Two days before admission, Captopril was initiated for high blood pressure (BP) as well as vitamin therapy for suspicion of a sars covid 19 infection, which was ruled out by a negative pcr covid test and a normal thoracic scan. The initial physical examination showed asthenia and a BP of 160/90 mmHg. Urinary labstix was negative. The biological analysis showed AKI creatinine rose from 80 to 230 and then to 530 µmol/l, anemia at 7 g/dl and moderate hyper eosinophilia at 700 elements/ml. A renal biopsy was not performed because of the presence of cysts, and the diagnosis of interstitial nephritis was suspected. The drug-induced origin was confirmed after having eliminated infectious and tumoral origin. The pharmacovigilance investigation incriminated captopril. Captopril was stopped and the patient was put on corticosteroids 0.5 mg/kg/d. The evolution was favorable with an improvement of the renal function (creatinine at 120 µmol/l one month later). Conclusions: Angiotensin-converting enzyme (ACE) inhibitors can cause an increase in serum creatinine or potassium levels in patients with renal failure, renal artery stenosis, heart failure, or hypovolemia, but are rarely reported to be involved as an etiology of AIN. We report one of the rare cases of captopril-induced AIN. No conflict of interest