| Autor: |
Acharya R; Department of Pediatrics, Nemours Children's Hospital, Orlando, FL 32827, USA., Clapp W; Division of Anatomic Pathology, Department of Pathology, University of Florida, Gainesville, FL 32610, USA., Upadhyay K; Division of Pediatric Nephrology, Department of Pediatrics, University of Florida, Gainesville, FL 32610, USA. |
| Jazyk: |
angličtina |
| Zdroj: |
Medicina (Kaunas, Lithuania) [Medicina (Kaunas)] 2024 Nov 09; Vol. 60 (11). Date of Electronic Publication: 2024 Nov 09. |
| DOI: |
10.3390/medicina60111846 |
| Abstrakt: |
Usage of novel non-tobacco oral nicotine delivery products (ONDPs) has been increasing among adolescents in the United States. It is presumed that they are less toxic than their tobacco-containing counterparts, but that has not been examined in controlled studies. Most of the studies have focused on non-renal manifestations of tobacco consumption via different means. The renal manifestations of non-tobacco ONDPs are not very well known, especially in immunocompromised patients. A 19-year-old male transplant recipient presented with flank pain and a few days' history of intake of ZYN R pouches. Immunosuppression was with tacrolimus, mycophenolate, and steroids. Baseline serum creatinine was 1.1-1.3 mg/dL. Laboratory evaluation showed elevated C-reactive protein, increased serum creatinine and blood urea nitrogen, leukocytosis, neutrophilia, and increased lactate dehydrogenase (LDH). Infectious disease work-up was negative. A kidney transplant biopsy showed severe acute tubular injury/necrosis (ATN) without evidence of rejection. Donor-specific antibodies were negative. Other etiologies of hemolysis were negative. He did not require renal replacement therapy. Kidney function and LDH improved gradually. The most recent follow-up eight months after presentation showed a serum creatinine level of 2.6 mg/dL with stable electrolytes, with eGFR of 35 mL/min/1.73 m 2 . Here, we describe a 19-year-old adolescent with a kidney transplant who sustained ATN leading to advanced chronic disease apparently following the usage of non-tobacco ONDP. Further larger studies are needed to study ATN as a possible renal manifestation of these next-generation products to raise awareness among the public. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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