Statin-induced rhabdomyolysis in renal transplant recipients: two cases reports
10.3760/cma.j.issn.0254-1785.2017.01.004
- VernacularTitle:使用他汀类药物导致肾移植受者横纹肌溶解症二例
- Author:
Guangjun LIU
;
Jianyong WU
;
Yiming WANG
;
Hongfeng HUANG
;
Wenhan PENG
;
Jianguo ZHANG
;
Jianghua CHEN
- Keywords:
kidney transplantation;
statins;
rhabdomyolysis;
acute renal failure
- From:
Chinese Journal of Organ Transplantation
2017;38(1):15-17
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the pathogenesis of the statin-induced rhabdomyolysis in renal transplant recipients.Methods We presented two renal transplant recipients who developed rhabdomyolysis in 2012 in our hospital.The clinical presentation,laboratory results,diagnosis and treatment of the two patients were analyzed retrospectively.The basic immunosuppressive agent of two patients was cyclosporine A.The recipients developed rhabdomyolysis following simvastatin lipidlowering therapy,and one patient suffered acute renal failure simultaneously.Acute tubular injury was confirmed by renal biopsy.Finally,the symptoms of the two patients were relieved completely,creatine kinase (CK) returned to normal after the satins discontinued and saline,sodium bicarbonate and diuretics were given.The renal failure patient underwent plasma exchange and CRRT,and the renal function returned to normal.Results The level of cyclosporine A should be monitored when the renal transplant patient was given statins,especially whose basic immunosuppressive agent was cyclosporine A.At the same time we should pay more attention to the symptoms of the myotoxic side effects and avoid using the drug which was also metabolized by CYP3A4.Conclusion Physicians should be aware of the potential risks of combined therapy of statins which are metabolized by P450CYP3A4 and cyclosporine A in transplant patients.If using it is advisable to begin with small dosage and monitor the CK level.
