膦甲酸钠注射液致急性肾功能衰竭1例

One case of acute renal failure induced by foscarnet sodium injection

1例70岁女性患者,因右侧季肋区、右侧腹部皮肤出现水疱,呈带状分布伴针扎样疼痛,诊断为带状疱疹,给予膦甲酸钠注射液90 mg·kg-1,qd,ivgtt,同时合并应用甲钴胺片、维生素B1片,阿昔洛韦软膏局部涂抹。第5天,患者四肢及面部出现水肿,伴恶心、食欲不振、尿少、皮肤瘙痒。实验室检查:血清肌酐542μmol·L-1,尿素氮28.6 mmol·L-1,尿比重1.005,考虑为急性肾功能衰竭,立即停用膦甲酸钠注射液,其他药物正常使用。入院后,给予限制液体入量,低盐、低脂、优质蛋白饮食。10 d后患者水肿消退,瘙痒消失,实验室复查:血清肌酐86μmol·L-1,尿素氮7.1 mmol·L-1,尿比重1.012,患者肾功能恢复正常。

A 70-year-old female patient with strip sample blisters on the right season costal area and right side of the abdominal skin and feeling prickling pain was diagnosed as herpes zoster. The patient was given foscarnet sodium injection （ 90 mg·kg^-1, qd, ivgtt）, mecobalamin, vitamin Bi and acyclovir ointment. On the fifth day, the limbs and face of the patient appeared edema, as well as nausea, loss of appetite, less urine, itchy skin. The patient＇s serum creatinine, urea nitrogen tendency and urine specific gravity were 542 mmol·L^-1, 28.6 mmol·L^-1 and 1.005 respectively, the patient was diagnosed as acute renal failure, foscarnet sodium injection was stopped immediately. After hospitalization, fluid intake was restricted, and the patient was given a low salt, low fat, high quality protein diet. Ten days later, the edema and pruritus disappeared, the patient＇s serum creatinine, urea nitrogen tendency and urine specific gravity changed to be 86 mmol·L^-1, 7.1 mmol·L^-1 and 1.012 with normal renal function.