Atypical Progression of Acute Renal Failure Associated with Cisplatin Chemotherapy / 대한내과학회지

ABSTRACT

Cisplatin is commonly used as chemotherapy for solid tumors. Its most important side effect is nephrotoxicity, which typically produces a gradual decline in renal function. Acute tubular necrosis is the usual pathological finding, while other findings are rare. A 75-year-old man presented to the emergency department (ED) with diarrhea and hypoglycemia. He was on 5-fluorouracil (5-FU)/cisplatin chemotherapy after a radical total gastrectomy for gastric cancer. Ten days earlier, he had been discharged after the third cycle of chemotherapy with normal renal function. When he arrived in the ED, he had azotemia (creatinine = 9.2 mg/dL) necessitating emergency hemodialysis. His renal function did not recover despite hydration and conservative treatment. Since he could not receive further chemotherapy due to the renal failure, he died 4 months later due to cancer progression. A renal biopsy performed 3 months after the renal failure showed acute tubular necrosis and severe interstitial fibrosis with normal glomeruli suggesting tubulointerstitial nephritis.