Abstract: FR-PO0738
Tirzepatide-Associated Minimal Change Disease: A Case Report
Session Information
- Glomerular Diseases: Membranous Nephropathy, FSGS, and Podocytopathies
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Khalid, Usbah, Crestwood Medical Center, Huntsville, Alabama, United States
- Nayab, Khudija, Crestwood Medical Center, Huntsville, Alabama, United States
- Sadiq, Muhammad Hamza, Crestwood Medical Center, Huntsville, Alabama, United States
- Razaq, Saeed, Crestwood Medical Center, Huntsville, Alabama, United States
- Habiba, Ume, University of Illinois Chicago, Chicago, Illinois, United States
- Wasay, Abdul, Crestwood Medical Center, Huntsville, Alabama, United States
Introduction
Tirzepatide is increasingly used for treatment of type 2 diabetes and obesity because of its glycemic, cardiovascular, and weight reduction benefits. Although incretin-based therapies are generally considered renoprotective, rare immune-mediated renal complications have been reported with GLP-1 receptor agonists. Minimal change disease (MCD) has not previously been described in association with tirzepatide therapy.
Case Description
A 52-year-old man with hypertension, hyperlipidemia, and obstructive sleep apnea presented with progressive bilateral lower extremity edema, orthopnea, abdominal distension, and marked scrotal swelling approximately two months after initiation of tirzepatide. Initial evaluation demonstrated acute kidney injury with serum creatinine of 1.8 mg/dL, nephrotic-range proteinuria (>9 g/day), hypoalbuminemia, hyperlipidemia, and volume overload. Serologic evaluation including HIV and hepatitis screening was negative. Kidney biopsy demonstrated diffuse podocyte foot process effacement without segmental sclerosis, consistent with minimal change disease with focal acute tubular injury. Tirzepatide was discontinued following biopsy confirmation. The patient was initiated on prednisone 80 mg daily with rapid clinical and biochemical improvement. Within 10 days, he experienced significant diuresis with 17-pound weight loss and marked improvement in edema. Repeat laboratory evaluation demonstrated recovery of kidney function (creatinine improved from 1.9 to 1.1 mg/dL), normalization of serum albumin (2.1 to 3.6 g/dL), and near-complete resolution of proteinuria (urine protein-creatinine ratio improved from 6.84 to 0.31).
Discussion
This case highlights a possible association between tirzepatide and biopsy-proven minimal change disease. Although causality cannot be definitively established, the temporal relationship, exclusion of alternative etiologies, and steroid-responsive remission support a potential drug-associated podocytopathy. As incretin-based therapies expand, clinicians should remain vigilant for atypical nephrotic presentations and consider early nephrology evaluation and kidney biopsy in patients who develop unexplained edema, proteinuria, or kidney dysfunction during therapy.