Kidney injury associated with fosravuconazole L-lysine ethanolate.

IF 2.2 4区医学 Q2 UROLOGY & NEPHROLOGY Clinical and Experimental Nephrology Pub Date : 2024-11-02 DOI:10.1007/s10157-024-02582-8

Takahiro Shinzato, Kojiro Nagai, Yuuki Hoshino, Yuuichi Fujiwara, Yoshihiro Yamamoto, Kikuno Ogura, Azusa Morishita, Takao Okawa, Kenta Ito, Masaaki Murakami, Ken Matsuo, Satoshi Tanaka

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Abstract

Background: Fosravuconazole L-lysine ethanolate (F-RVCZ) is a prodrug of ravuconazole and a triazole antifungal drug used for the treatment of onychomycosis. It has been reported in previous studies that the kidney injury caused by F-RVCZ is 1% or less.

Methods: Serum creatinine levels were compared, and glomerular filtration rate and urine protein were estimated before and after starting the administration of F-RVCZ, as well as after the end of the administration period. The cause of kidney injury was investigated using renal pathology, and risk factors were also investigated.

Results: F-RVCZ was administered to 46 patients. Ten of these patients were excluded because three were maintenance dialysis patients and seven were not measured for serum creatinine. Remaining 36 patients were included in the analyses. Kidney injury occurred in 27.8% of patients treated with F-RVCZ; this condition persisted in 10% of patients after the end of the administration period. No changes were observed in the urinalysis after the administration of F-RVCZ. A kidney biopsy was performed in one patient, but no lesions were found that could be the cause of kidney injury. Patients who developed kidney injury were significantly more likely to be receiving angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (odds ratio 18.9, 95% confidential interval: 1.69-210, p = 0.0169).

Conclusion: Kidney injury is caused by F-RVCZ more frequently than previously reported, but the mechanism remains unclear.

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与 L-赖氨酸乙醇酸磷曲康唑有关的肾损伤。

背景：左旋赖氨酸乙醇唑（Fosravuconazole L-lysine ethanolate，F-RVCZ）是雷武康唑的原药，也是一种三唑类抗真菌药物，用于治疗甲癣。据以往研究报告，F-RVCZ 造成的肾损伤为 1%或更低：方法：比较血清肌酐水平，并在开始服用 F-RVCZ 前后以及用药结束后估算肾小球滤过率和尿蛋白。通过肾脏病理学调查了肾损伤的原因，并对风险因素进行了调查：46名患者接受了F-RVCZ治疗。结果：46 名患者接受了 F-RVCZ 治疗，其中 10 名患者被排除在外，因为其中 3 名是维持性透析患者，7 名未测量血清肌酐。其余 36 名患者纳入分析。在接受 F-RVCZ 治疗的患者中，27.8% 的患者出现了肾损伤；10% 的患者在用药期结束后仍出现这种情况。服用 F-RVCZ 后，尿液分析未发现任何变化。对一名患者进行了肾活检，但未发现可能导致肾损伤的病变。出现肾损伤的患者更有可能服用血管紧张素转换酶抑制剂或血管紧张素 II 受体阻滞剂（几率比 18.9，95% 置信区间：1.69-210，P = 0.0169）：结论：F-RVCZ导致肾损伤的频率高于以往的报道，但其机制仍不清楚。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Nephrology UROLOGY & NEPHROLOGY-

CiteScore

4.10

自引率

4.30%

发文量

135

审稿时长

4-8 weeks

期刊介绍： Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.