Clozapine-Induced Acute Interstitial Nephritis: A Systematic Review
Abstract
BACKGROUND
Clozapine, an atypical antipsychotic used primarily for treatment-resistant schizophrenia, has been associated with a wide range of side effects, including the rare but serious complication of acute interstitial nephritis (AIN). This systematic review aimed to summarise published cases of clozapine-induced AIN, focusing on clinical presentations, diagnostic findings, treatment approaches, and patient outcomes to improve awareness and management of this adverse reaction.
METHODS
A systematic search of the databases Medline, Embase, Cochrane Library, and PsycINFO was conducted according to PRISMA guidelines. Two independent reviewers assessed each study for eligibility and study quality, and extracted the data.
RESULTS
A total of 13 cases were included in the final analysis. The mean treatment duration of clozapine before AIN onset was 34.8 days. Doses of clozapine ranged from 100 mg to 700 mg daily, with a mean dose of 281.8 mg. Seven cases were noted to be treated concomitantly with sodium valproate. Symptomatology was diverse, and the most common symptom described was fever (8/13 cases). Clozapine was discontinued in all cases. All cases subsequently had resolution of their physical symptoms, and renal function improved in 92% of cases, however one patient developed permanent chronic kidney disease. Other than clozapine cessation, additional treatments utilized included oral corticosteroid therapy, intravenous corticosteroid therapy, and intravenous fluids. Three…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Drug repositioning: a brief overview
- Cyclic nucleotide phosphodiesterases in Drosophila melanogaster
- Time-resolved in silico modeling of fine-tuned cAMP signaling in platelets: feedback loops, titrated phosphorylations and pharmacological modulation
- Current View on Green Tea Catechins Formulations, Their Interactions with Selected Drugs, and Prospective Applications for Various Health Conditions
- In silico Structure-based Identification of Novel Acetylcholinesterase Inhibitors Against Alzheimer’s Disease
- Development and In Vitro Evaluation of Controlled Release Viagra® Containing Poloxamer-188 Using Gastroplus™ PBPK Modeling Software for In Vivo Predictions and Pharmacokinetic Assessments
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.