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NDT Plus Advance Access originally published online on June 24, 2008
NDT Plus 2008 1(5):286-288; doi:10.1093/ndtplus/sfn076
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© The Author [2008].
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org

Water intoxication induced by low-dose oral cyclophosphamide in a patient with anti-neutrophil cytoplasmic antibody-related glomerulonephritis

Akihiko Kato1, Takeshi Sugiura2, Tatsuo Yamamoto3, Taro Misaki4, Takayuki Tsuji4, Yukitoshi Sakao4, Masaaki Sakakima4, Hideo Yasuda4, Yoshihide Fujigaki4 and Akira Hishida4

1 Division of Blood Purification, Hamamatsu University School of Medicine
2 Department of Nephrology, Seirei Mikatahara General Hospital
3 Department of Health and Nutritional Science, Hamamatsu University
4 First Department of Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan

Correspondence: Correspondence and offprint requests to: Akihiko Kato, Division of Blood Purification, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka 431-3192, Japan. Tel. and Fax: +81-53-435-2756; E-mail: a.kato{at}hama-med.ac.jp


  Abstract

We reported the case of a 70-year-old woman with moderate renal failure due to anti-neutrophil cytoplasmic antibody-related glomerulonephritis who developed symptomatic water intoxication (serum Na: 108 mEq/L) following treatment with oral low-dose cyclophosphamide (CY) (50mg/day). Estimated glomerular filtration rate was 29.5 mL/min/1.73 m2. She had drunk >2 L of fluid in 12 h prior to the development of cerebral oedema. This rare case suggests that oral low-dose CY could be an occult cause of water intoxication in patients with chronic kidney disease taking large fluid volumes.

Key Words: chronic kidney disease • cyclophosphamide • fluid intake • symptomatic hyponatraemia

Received for publication April 15, 2008. Accepted for publication May 30, 2008.


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