Alogliptin-Induced Minimal Change Nephrotic Syndrome and Interstitial Nephritis

Abstract

Alogliptin is one of the dipeptidyl peptidase-4 inhibitors used to treat patients with type 2 diabetes. Little is known about the nephrotoxicity associated with alogliptin, such as nephrotic syndrome or interstitial nephritis. We report a biopsy-proven rare case of minimal change nephrotic syndrome and interstitial nephritis induced by alogliptin. A 68-year-old man who had been prescribed alogliptin was hospitalized for nephrotic syndrome. On admission, serum creatinine level was elevated with increased urinary β 2-microglobulin and N-acetyl-β-D-glucosaminidase excretion. Kidney biopsy revealed minor glomerular abnormalities and interstitial nephritis, and gallium-67 scintigraphy showed uptake in both kidneys. A drug lymphocyte stimulation test for alogliptin was positive. With discontinuation of alogliptin treatment alone, serum creatinine level normalized in parallel with urine β 2-microglobulin and N-acetyl-β-D-glucosaminidase levels. In addition, complete remission of nephrotic syndrome was observed. Drug-induced dual pathology has not been previously reported with alogliptin. In summary, clinicians should keep in mind that alogliptin can induce minimal change nephrotic syndrome and interstitial nephritis.

Effect of Alogliptin and L-carnitine on Nephrotoxicity-Inducedby Gentamicin in Rats

“…One of DPP-4 inhibitor given to persons with type 2diabetes is analogliptin. The gathered data is consistent with their conclusions, according to the scientists [39] who examined the case of a 68-yearold male who had type II diabetes, hypertension, and cerebral infarction. ALO (25 mg/d) therapy reduced proteinuria, serum creatinine levels, and 2-microglobulin and -D-glucosaminidase excretion in the urine (NAG).…”