奥利司他致草酸盐结晶相关急性肾损伤1例  

Oxalate crystal-related acute renal injury caused by orlistat:A case report

作　　者：崔鑫源 陈晓君[1] 李毅夫[1] 符晓[1] 宋盼爱[1] 肖力[1] 孙林[1] 刘虹[1] 朱雪婧[1] 袁曙光[1] CUI Xinyuan;CHEN Xiaojun;LI Yifu;FU Xiao;SONG Pan’ai;XIAO Li;SUN Lin;LIU Hong;ZHU Xuejing;YUAN Shuguang(Department of Nephrology,Second Xiangya Hospital,Central South University,Institute of Nephrology,Central South University,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院肾内科,中南大学肾脏病研究所,长沙410011

出　　处：《中南大学学报（医学版）》2022年第5期583-587,共5页Journal of Central South University ：Medical Science

基　　金：国家自然科学基金(81300600,81800649,82100734);湖南省自然科学基金(2018JJ3728,2018JJ2596);湖南省卫生健康委员会科研课题(20200807);中南大学创新创业教育课程建设项目(2020CXKZ02)。

摘　　要：报告1例奥利司他致草酸盐结晶相关急性肾损伤病例,该患者因肾病综合征、急性肾损伤入院,肾活检病理检查发现肾小管内草酸盐结晶。患者自诉因减肥而规律服用奥利司他1年余,平日喜饮蔬菜汤和浓凉茶,奥利司他作为肠道脂肪酶抑制剂可能导致继发性高草酸尿症,即肠源性高草酸尿症;饮食习惯是奥利司他致高草酸尿症的共同促发因素。本例患者停药后肾功能有所恢复。临床医生在处理不明原因急性肾损伤患者时应注意排查包括奥利司他在内的药物相关急性肾损伤,必要时可行肾活检。此外,服用该药的减肥人群应注意药物的不良反应,及时调整饮食习惯。We reported a case of oxalate crystal-related acute kidney injury caused by orlistat.The patient was admitted for nephrotic syndrome and acute kidney injury.The pathomorphological assessment of renal biopsy showed intratubular oxalate crystals.The patient reported that she had taken orlistat regularly to loss weight for more than a year.This patient had a habit of drinking vegetable soup and strong herbal tea daily.Orlistat,an intestinal lipase inhibitor,may cause secondary hyperoxaluria,that is,intestinal hyperoxaluria.Dietary habits could be a common precipitating factor for orlistat-relevant hyperoxaluria.It was comprehensively considered to be oxalate crystal-related acute renal injury,and the patient’s renal function recovered gradually after drug withdrawal.Clinicians should pay attention to screening drug-related acute kidney injury including orlistat when observing patients with unexplained acute kidney injury,and renal biopsy should be performed if necessary.It is also important to warn people who take the orlistat for weight loss about the side effects of this drug so as to adjust the eating habits.

关 键 词：奥利司他 高草酸尿症 急性草酸性肾病 

分 类 号：R692[医药卫生—泌尿科学]