Русский
Acute kidney damage due to statin taken: case description and literature review
DOI: https://dx.doi.org/10.18565/nephrology.2025.1.61-66
Zubeev P.S., Kharlamova O.V., Motylev I.M., Zubeeva G.N., Suslova O.A., Shilov E.M.
1) City Hospital No. 33, Nizhny Novgorod, Russia; 2) Privolzhsky Research Medical University, Nizhny Novgorod, Russia; 3) First State Medical University named after. I. M. Sechenova, Moscow, Russia
A case of acute kidney injury while taking statins is presented, demonstrating the difficulties of differential diagnosis of kidney damage in comorbid elderly patients. An 83-year-old man was delivered in serious condition from another hospital with a diagnosis of end-stage CKD. Upon admission, an increase in myoglobin to 262144 was noted, CPK total. >80 ULN (upper limit of normal), LDH >8 ULN, AlAt >30 ULN, AST >19 ULN, creatinine – 589 U/l, urea – 32.7 mmol/l, as a result of which the diagnosis was revised in favor of SAMS: rhabdomyolysis with the development of myoglobinuric nephrosis (a variant of tubulointerstitial nephritis), statin-induced liver damage (drug-induced hepatitis). Four risk factors for the development of SAMS were immediately identified: old age, hypothyroidism, impaired renal and liver function, high-dose statin therapy (atorvastatin 80 mg, rosuvastatin 40 mg per day). In the hospital, the patient received complex therapy (including: acute hemodialysis, plasmapheresis, correction of anemia, forced diuresis, correction of hypothyroidism), after which he was discharged in satisfactory condition.
Thus, when prescribing statins, special attention should be paid to comorbid elderly patients who already have kidney disease, thyroid disease and other risk factors for the development of adverse reactions, and, if possible, eliminate them. Then select the dose individually and promptly assess the safety of the therapy.
About the Autors
Zubeev Pavel Sergeevich – Dr. med. Sci., Professor Department of Emergency Medical Care, Federal Postgraduate Education, Head. Department, Privolzhsky Research Medical University. Address: 603095 Nizhny Novgorod, pl. Minin and Pozharsky, d. 10/1; tel.: 8 (908) 762-05-30; e-mail: zubeev@rambler.ru.
: https://orcid.org/0009-0004-8616-2541.
Kharlamova Olga Viktorovna – Candidate of Medical Sciences Professor of the Department Emergency Medical Care, Privolzhsky Research Medical University, Federal Postgraduate Education. Address: 603095 Nizhny Novgorod, pl. Minin and Pozharsky, d. 10/1; tel.: 8 (910) 877-29-82, 8 (831) 258-24-16;
e-mail: olgakharlamowa@yandex.ru. ORCID: https://orcid.org/0009-0002-0551-0504.
Motylev Igor Mikhailovich – Ch. freelance clinical pharmacologist of the Ministry of Health of the Nizhny Novgorod Region, deputy chief physician of the GBUZ NO “City Hospital No. 33” for medical affairs. Address: 603076 Nizhny Novgorod, Lenin Ave., d. 54; tel.: 8 (951) 910-69-92; e-mail: moim1@yandex.ru.
ORCID: https://orcid.org/0009-0007-2098-6152.
Zubeeva Galina Nikolaevna – Candidate of Medical Sciences, Assistant Professor Department of Emergency Medical Care Privolzhsky Research Medical University, Federal Postgraduate Education. Address: 603095 Nizhny Novgorod, pl. Minin and Pozharsky, d. 10/1; tel.: 8 (903) 052-52-53; e-mail: gzubeeva@yandex.ru.
ORCID: https://orcid.org/0009-0002-5760-0472.
Suslova Olga Alexandrovna – Candidate of Medical Sciences Associate Professor of the Department of Emergency Medical Care, Privolzhsky Research Medical University, Federal Postgraduate Education. Address: 603095 Nizhny Novgorod, pl. Minin and Pozharsky, d. 10/1; tel.: 8 (903) 609-44-88; e-mail: suslova.olg@yandex.ru.
ORCID: https://orcid.org/0009-0009-8117-0872.
Shilov Evgeniy Mikhailovich – MD. sciences, professor, Head department of Nephrology and Hemodialysis First Moscow State Medical University named after.
THEM. Sechenov. Address: 119991 Moscow, GSP-1, str. Trubetskaya, d. 8, building 2; e-mail: emshilov@gmail.ru. ORCID: https://orcid.org/0000-0002-2111-191X.
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