|Home | About | Journals | Submit | Contact Us | Français|
Reports of acute renal failure in patients with cystic fibrosis began to appear around the turn of the millennium. Now a survey of UK cystic fibrosis centres (Carol Bertenshaw and colleagues. Thorax. Published online 18 Jan 2007; doi: 10.1136/thx.2006.067595) has provided more reports of patients with cystic fibrosis and acute renal failure.
A questionnaire was sent to 99 doctors in 56 centres (30 paediatric and 26 adult centres). Replies were received from 94 doctors in 55 centres and information was obtained about 55 possible cases of acute renal failure between 1997 and 2004. Study consent was obtained for 26 of these and the diagnosis of acute renal failure was confirmed in 24 (19 children under the age of 16 years). The oldest patient was 31 years old. The estimated incidence was 4.6–10.5 cases of acute renal failure per 10000 cases of cystic fibrosis per year. In 21 cases an aminoglycoside antibiotic had been given in the week before the onset of acute renal failure (gentamicin in 16 cases). Six cases had cystic fibrosis related diabetes. Renal biopsy in seven cases showed acute tubular necrosis in six, all associated with gentamicin. Thirteen patients (54%) needed renal dialysis, and 22 patients (92%) made a full recovery. One patient, with diabetic nephropathy, needed long‐term dialysis, and one needed long‐term antihypertensive treatment.
Acute renal failure in patients with cystic fibrosis is usually related to use of an aminoglycoside, particularly gentamicin. A case–control study is planned to delineate risk factors more fully.