Roxadustat-induced acute heart failure with acute exacerbation of renal dysfunction
10.3760/cma.j.cn114015-20240130-00073
- VernacularTitle:罗沙司他致急性心力衰竭伴肾功能不全急性加重
- Author:
Wenting ZHU
1
;
Qiujiang BAI
;
Li NIE
Author Information
1. 南京大学医学院附属泰康仙林鼓楼医院药学部，南京 210023
- Publication Type:Journal Article
- Keywords:
Heart failure;
Hyperkalemia;
Renal insufficiency;
Roxadustat;
Hypoxia inducible factor-prolyl hydroxylase inhibitor;
Adverse drug reactions
- From:
Adverse Drug Reactions Journal
2024;26(12):762-764
- CountryChina
- Language:Chinese
-
Abstract:
A 78-year-old female patient with type 2 diabetes for 30 years, hypertension for more than 10 years, diabetes nephropathy for 4 years, and renal anemia for several years additionally received roxadustat (70 mg thrice per week orally) for anemia. After 5 days, the patient developed sudden chest tightness, asthma, acute left heart failure, and depressed edema of both lower limbs. The electrocardiogram showed sinus arrest, escape rhythm, and a heart rate of 40 beats per minute. Laboratory test results showed blood pH 7.31, blood potassium 5.3 mmol/L, blood creatinine 304 μmol/L, B-type natriuretic peptide 1 280.0 ng/L, high-sensitivity troponin T 0.042 μg/L, and creatine kinase MB 0.83 μg/L. Acute left heart failure, hyperkalemia, and metabolic acidosis caused by roxadustat were considered. Roxadustat and other long-term oral medication such as hypoglycemic and antihypertensive drugs were discontinued. Symptomatic treatments such as sodium bicarbonate, insulin, furosemide, calcium gluconate, and blood filtration were given. Two days later,the patient′s heart rate and blood potassium returned to normal; 7 days later, the patient′s B-type natriuretic peptide was 168.0 ng/L, blood creatinine was 170 μmol/L, and blood potassium was 4.13 mmol/L. The patient had no chest tightness or asthma, and no edema in both lower limbs. Long-term oral medication such as hypoglycemic and antihypertensive drugs were given again. At a 1 month follow-up, the patient did not experience chest tightness or asthma, and the electrolyte levels were normal.
