Document Detail


Acute tubular necrosis associated with chromium picolinate-containing dietary supplement.
MedLine Citation:
PMID:  16492795     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To report a case of acute tubular necrosis associated with the use of a chromium picolinate-containing dietary supplement. CASE SUMMARY: A 24-year-old white male who had been ingesting a dietary supplement (Arsenal X) for 2 weeks during his workout sessions developed acute renal failure. Radiologic investigation showed the presence of a solitary right kidney, and an open renal biopsy confirmed features of acute tubular necrosis. He developed significant renal impairment that required hemodialysis. He was also treated with plasmapheresis and steroids, as a diagnosis of pulmonary-renal syndrome was entertained early in the disease course, which was subsequently ruled out. The patient ultimately recovered and, on outpatient visits, was noted to have normal renal function. DISCUSSION: The use of dietary supplements has become increasingly popular in the US, and these supplements are not subject to stringent premarketing testing or postmarketing surveillance. The main ingredients in the supplement discussed here were chromium picolinate, Sida cordifolia, synephrine, and guarana. An objective causality assessment using the Naranjo probability scale indicated a probable association between the use of this supplement and the development of acute renal failure in this patient. CONCLUSIONS: Current information regarding the beneficial effects of trivalent chromium is not very robust; therefore, use of this agent cannot be recommended at this time. This report serves as an important reminder to the public, as well as healthcare providers, of potential nephrotoxic reactions to dietary supplements.
Authors:
Sachin Wani; Celia Weskamp; Jeffrey Marple; Leslie Spry
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2006-02-21
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  40     ISSN:  1060-0280     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-03-07     Completed Date:  2006-04-26     Revised Date:  2006-10-13    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  563-6     Citation Subset:  IM    
Affiliation:
BryanLGH Medical Center, Internal Medicine, University of Nebraska Medical Center, Lincoln, 68502, USA. sachinwani10@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Inflammatory Agents / therapeutic use
Dietary Supplements / adverse effects*
Humans
Kidney Tubular Necrosis, Acute / chemically induced*,  pathology
Male
Picolinic Acids / adverse effects*
Plasmapheresis
Renal Dialysis
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Picolinic Acids; 98-98-6/picolinic acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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