07 December 2025
: Case report 
Acute Kidney Injury from Mononuclear Cell-Predominated Interstitial Nephritis After Introduction of a Glucagon-Like Peptide-1 Receptor Agonist: A Case Report
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Rare disease, Adverse events of drug therapy
Raweekarn Itsathitpaisarn BF 1, Nattavong Suksawad F 2, Watsapol Wongwikrom F 2, Jerasit Surintrspanont
B 3,4, Thana Thongsricome AE 1,5*
DOI: 10.12659/AJCR.949913
Am J Case Rep 2025; 26:e949913
Table 1 Case reports of glucagon-like peptide-1 receptor antagonist-induced biopsy-proven acute interstitial nephritis.
| Author, Year [Ref] | Age (year)/sex [initial eGFR] | Medication | Onset of kidney injury after medication | Presenting symptoms and signs | Renal biopsy findings | Treatments | Time to recovery and recovery type |
|---|---|---|---|---|---|---|---|
| Nandakoban et al, 2013 []19 | 58/male [59 mL/min/ 1.73 m] | Exenatide 5 mcg twice daily | 2 months | Malaise, anorexia, flank discomfort | Moderately severe diffused tubulointerstitial nephritis infiltrated with numerous eosinophils | Discontinue exenatide, start insulin therapy, prednisolone 50 mg per day | 4 months/partial recovery |
| Gariani et al, 2014 []20 | 83/male [32 mL/min/ 1.73 m] | Liraglutide (no specified dose) | 2 months | bilateral leg edema, crackles in both lungs | Diffuse tubulointerstitial nephritis infiltrated with numerous eosinophils | Discontinue liraglutide, steroids, temporary dialysis | N/A/partial recovery |
| Chaudhury et al, 2021 []11 | 59/male [35 mL/min/ 1.73 m] | Liraglutide (no specified dose) | 5 months | N/A | Mild focal tubulitis infiltrated with many eosinophils, marked interstitial fibrosis and tubular atrophy | Discontinue liraglutide, start linagliptin, no steroid therapy | No recovery, long-term peritoneal dialysis |
| Leehey et al, 2021 []21 | 80/female [35 mL/min/ 1.73 m] | Semaglutide 0.25 to 0.5 mg/week | 4 months | Increasing leg edema | Acute tubulointerstitial infiltrated with lymphocytes, plasma cells, and eosinophils, 23 of 36 (64%) glomeruli: globally sclerosed | Discontinue Semaglutide, no steroid therapy | No recovery (not mention whether the patient required dialysis) |
| Borkum et al, 2022 []22 | 30/male [91 mL/min/ 1.73 m] | Semaglutide 0.25 to 0.5 mg/week | 6 weeks | Malaise, shortness of breath | Acute tubulointerstitial nephritis infiltrated with lymphocytes, plasma cells, and eosinophils | Discontinue Semaglutide, prednisolone 1 mg/kg/day | 1 month/complete recovery |
| Komala, Renthawa, 2022 []23 | 78/male [no specified eGFR] | Dulaglutide (no specified dose) | 4 weeks (Patient had received exenatide for several years before without adverse event) | Lethargy, loss of appetite, nausea | Acute tubulointerstitial nephritis infiltrated with eosinophils, partial scarring | Discontinue liraglutide, prednisolone 50 mg per day, temporary dialysis | 2 weeks/complete recovery |
| eGFR – estimated glomerular filtration rate; N/A – not applicable. | |||||||