Acute Tubular Necrosis Attributed to High-Dose Everolimus with High-Potency Bisphosphonates for Advanced Breast Cancer: A Case Report.

IF 1.8 4区医学 Q2 UROLOGY & NEPHROLOGY Nephron Pub Date : 2025-01-01 Epub Date: 2025-02-03 DOI:10.1159/000543924

Itamar Loewenstein, Nimrod Orr Urtreger, Doron Schwartz, Asia Zubkov, Merav Ingbir

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Abstract

Introduction: Everolimus (EVR)-induced kidney injury is rarely reported. Conversely, acute tubular necrosis (ATN) is a recognized complication of high-dose bisphosphonate therapy.

Case presentation: SM, a 69-year-old female patient with advanced breast cancer, developed severe kidney injury necessitating renal replacement therapy (RRT) shortly after initiating EVR treatment, while concurrently receiving chronic high-potency bisphosphonate therapy. Kidney biopsy confirmed ATN. Upon discontinuation of both EVR and bisphosphonates, her renal function gradually improved over several months, leading to the cessation of RRT. At a 2-year follow-up, her kidney function has returned to baseline.

Conclusion: In this case report, we outline the patient's clinical course and provide a pathophysiological rationale for the synergistic effect of EVR and bisphosphonates in promoting ATN. With the increasing use of EVR in various oncologic indications, we emphasize the reversible nature of this kidney injury and stress the importance of timely recognition and intervention.

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晚期乳腺癌高剂量依维莫司联合高效双膦酸盐治疗急性小管坏死1例报告。

依维莫司（EVR）引起的肾损伤很少报道。相反，急性肾小管坏死（ATN）是高剂量双膦酸盐治疗的公认并发症。病例介绍：SM， 69岁晚期乳腺癌女性患者，在开始EVR治疗后不久发生严重肾损伤，需要肾替代治疗（RRT），同时接受慢性高效双膦酸盐治疗。肾活检证实ATN。停用EVR和双膦酸盐后，她的肾功能在几个月内逐渐改善，导致RRT停止。经过两年的随访，她的肾功能已恢复到基线水平。结论：在本病例报告中，我们概述了患者的临床过程，并为EVR和双膦酸盐在促进ATN中的协同作用提供了病理生理学基础。随着EVR在各种肿瘤适应症中的应用越来越多，我们强调这种肾损伤的可逆性，并强调及时识别和干预的重要性。

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

Nephron UROLOGY & NEPHROLOGY-

CiteScore

5.00

自引率

0.00%

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期刊介绍： ''Nephron'' comprises three sections, which are each under the editorship of internationally recognized leaders and served by specialized Associate Editors. Apart from high-quality original research, ''Nephron'' publishes invited reviews/minireviews on up-to-date topics. Papers undergo an innovative and transparent peer review process encompassing a Presentation Report which assesses and summarizes the presentation of the paper in an unbiased and standardized way.