Orlistat and acute kidney injury: an analysis of 953 patients.

摘要

Obesity is a significant health problem that is growing in prevalence. Orlistat (Xenical; Roche, Basel, Switzerland), an inhibitor of pancreatic lipases that limits the intestinal absorption of dietary fat, has proven effective in augmenting weight loss.3'4 In the United States, orlistat is available over the counter and by prescription. Single-person case reports have recently suggested that orlistat may cause oxalate-induced acute kidney injury (AKI). The putative mechanism is similar to enteric hyperoxalaturia in which unabsorbed dietary fat binds enteric calcium and reduces its ability to bind and sequester oxalate in the gut. This results in excessive absorption of free oxalate and subsequent deposition in the renal parenchyma. To explore the relationship between orlistat and AKI, we conducted a before-and after-analysis of incident orlistat users.