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Abstract: FR-PO078

In Search of Declining Weight, a Significant Decline in Kidney Function: A Rare Case of Liraglutide-Induced Interstitial Nephritis

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention


  • Jain, Deepika, Jersey City Medical Center, Jersey City, New Jersey, United States
  • Riaz, Ramsha, Jersey City Medical Center, Jersey City, New Jersey, United States
  • Ott, William P., Jersey City Medical Center, Jersey City, New Jersey, United States
  • Sapkota, Subash, Jersey City Medical Center, Jersey City, New Jersey, United States

Liraglutide is a glucagon-like peptide-1 (GLP-1) agonist known to improve glycemic control in diabetics and result in weight loss. There are reports of GLP-1 agonists causing acute interstitial nephritis (AIN) primarily in the setting of preceding gastrointestinal symptoms or pre-existing chronic kidney disease (CKD). We present a case of rapid decline in renal function one month after starting liraglutide with concomitant use of an angiotensin-receptor blocker (ARB).

Case Description

A 50 year-old Caucasian male with history of hypertension, dyslipidemia, obesity presented to the hospital for acute renal failure noted as an outpatient from a baseline creatinine of 1.15 mg/dL and GFR 78 mL/min/1.73m2. Patient was asymptomatic without any hematuria, dysuria, decreased urinary output, rashes, or respiratory complaints. Home medications included olmesartan-HCTZ 40/25 mg, pravastatin 80 mg, and the recent addition of Liraglutide (Saxenda) one month ago to aid with weight loss. Labs on presentation were notable for significant renal dysfunction with BUN/Creatinine of 53/4.71 mg/dL and eGFR 14 mL/min/1.73m2. Urinalysis showed a protein of 100 mg/dL (1-2+) and protein-creatinine ratio of 9.04 mg/mg. Further work-up including ANA, anti-GBM Ab, HIV, ANCA, Ds-DNA Ab, C3/C4 was normal. A renal biopsy showed interstitial inflammatory infiltration, focal interstitial edema, and mild tubular injury. No evidence of acute glomerulonephritis, immune complex glomerulopathy, or paraprotein related nephropathy was identified. Patient was extensively counseled to discontinue use of both ARB and liraglutide, however he declined to stop liraglutide since he had been achieving excellent weight loss results.


Drug-induced AIN is often considered when unexplained renal insufficiency is detected or when an abnormal urinalysis is noted in someone who has been exposed to medications known to cause AIN, with renal biopsy being the gold standard investigation to make a definitive diagnosis. Our case highlights a patient with no CKD and GI symptoms with rapid elevation of creatinine following initiation of liraglutide for weight loss. This effect seems to have been compounded by existing use of ARB, which highlights importance of closer and more frequent monitoring of patients on GLP-1 agonists to prevent unwarranted adverse effects.