Acetazolamide에 의해 발생한 핍뇨성 급성신부전 1예
A Case of Oliguric Acute Renal Failure Caused by Acetazolamide
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Acetazolamide는 탄산탈수효소 억제제로 고령이나 신기능이 저하된 환자에서 대사성 산증이나 급성신부전을 일으킬 수 있다. 저자들은 녹내장 치료를 위해 acetazolamide를 복용하던 정상 신기능의 당뇨병 환자에서 대사성산증을 동반한 핍뇨성 급성신부전을 혈액투석으로 치료한 증례를 경험하였다. 따라서 정상 신기능을 가진 녹내장 환자에서도 acetazolamide를 사용하는 경우 신부전의 위험성을 고려하여 주의 깊은 관찰이 필요할 것으로 생각된다.
Abstract
Acetazolamide is a carbonic anhydrase inhibitor commonly used to treat glaucoma. It can cause metabolic acidosis and renal failure in the elderly and patients with chronic renal insufficiency. We report oliguric acute renal failure (ARF) caused by a conventional dose of acetazolamide for glaucoma in a patient with normal renal function. A 56-year-old woman with 20-year history of diabetes had general weakness, decreased urine output, nausea, and vomiting for 3 days. For the past 2 weeks, her glaucoma had been treated with acetazolamide. Blood-gas analysis showed pH 7.02, PCO2 27 mmHg, PO2 135 mmHg, and HCO3- 7.0 mmol/L. Her BUN was 65 mg/dL and creatinine, 9.1 mg/dL. She recovered after hemodialysis and hydration. Acetazolamide may cause severe ARF, even in patients with normal renal function, suggesting the importance of careful monitoring of renal function in patients taking acetazolamide. (Korean J Med 2012;83:664-667)
참고문헌 (10)
- Hilvo M, "Parkkila S. Recent advances in research on the most novel carbonic anhydrases, CA XIII and XV", Curr Pharm Des, 14, pp.672~678 (2008)
- Kaur IP, "Acetazolamide: future perspective in topical glaucoma therapeutics", Int J Pharm, 248, pp.1~14 (2002)
- López-Menchero R, "Anuric acute renal failure due to acetazolamide", Nefrologia, 26, pp.755~756 (2006)
- Maisey DN, "Acetazolamide and symptomatic metabolic acidosis in mild renal failure", Br Med J, 283, pp.1527~1528 (1981)
- Heller I, "Significant metabolic acidosis induced by acetazolamide: not a rare complication", Arch Intern Med, 145, pp.1815~1817 (1985)
- Higenbottam T, "Acute renal failure from the use of acetazolamide (Diamox)", Postgrad Med J, 54, pp.127~128 (1978)
- Epelde Gonzalo F, "Acetazolamide induced acute renal failure without evidence of renal obstruction", An Med Interna, 15, pp.451~ (1998)
- Siklos P, "Severe acidosis from acetazolamide in a diabetic patient", Curr Med Res Opin, 6, pp.284~286 (1979)
- Yeyati NL, "Mechanism of acetazolamide-induced rise in renal vascular resistance assessed in the dog whole kidney", Ren Physiol Biochem, 15, pp.99~105 (1992)
- Shim YW, "Clinical observations of acute renal failure", Korean J Med, 28, pp.375~381 (1985)