{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T12:55:22Z","timestamp":1780059322252,"version":"3.54.0"},"reference-count":28,"publisher":"The Endocrine Society","issue":"6","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We report a case of interstitial nephritis, likely secondary to tirzepatide. A 66-year-old man with type 2 diabetes, stage 3b chronic kidney disease, and other metabolic comorbidities experienced a progressive decline in renal function. Serum creatinine rose from 1.1\u2005mg\/dL (SI: 97.2\u2005\u00b5mol\/L) to 2.11\u2005mg\/dL (SI: 186.5\u2005\u00b5mol\/L) (reference range, 0.6-1.2\u2005mg\/dL [SI: 53-106\u2005\u00b5mol\/L]); estimated glomerular filtration rate (eGFR) fell from 68 to 34\u2005mL\/min\/1.73\u2005m2 over 8 months while receiving escalating doses of tirzepatide. Despite cessation of other medications and supportive care, renal dysfunction persisted. Kidney biopsy revealed chronic active tubulointerstitial nephritis with eosinophilic infiltrates and fibrosis implicating tirzepatide as the likely cause. Discontinuation of tirzepatide and initiation of prednisone resulted in significant improvement (serum creatinine measured 1.68\u2005mg\/dL (SI: 148.5\u2005\u00b5mol\/L) at 1 month and stabilized at 1.78\u2005mg\/dL (SI: 157.3\u2005\u00b5mol\/L); eGFR improved from 34\u2005mL\/min\/1.73\u2005m2 to 42\u2005mL\/min\/1.73\u2005m2 by 3 months). This case highlights a rare, biopsy-proven adverse renal effect of tirzepatide and underscores the importance of considering interstitial nephritis in patients with unexplained kidney injury on incretin mimetic therapy. Although glucagon-like peptide-1 receptor agonists benefits outweigh rare risks of nephrotoxicity, regular monitoring of creatinine monitoring is advised.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag125","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T11:45:25Z","timestamp":1775821525000},"source":"Crossref","is-referenced-by-count":1,"title":["Tirzepatide-associated interstitial kidney injury"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0783-5088","authenticated-orcid":false,"given":"Mohamed","family":"Eldib","sequence":"first","affiliation":[{"name":"Endocrinology and Metabolism Institute, Cleveland Clinic , Cleveland, OH 44195 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaidehi","family":"Mendpara","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cleveland Clinic , Cleveland, OH 44195 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leal","family":"Herlitz","sequence":"additional","affiliation":[{"name":"Department of Anatomic Pathology, Cleveland Clinic , Cleveland, OH 44195 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paloma","family":"Rodriguez Alvarez","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism Institute, Cleveland Clinic , Cleveland, OH 44195 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagmeet","family":"Dhingra","sequence":"additional","affiliation":[{"name":"Department of Kidney Medicine, Cleveland Clinic Foundation , Cleveland, OH 44195 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila Zeinab","family":"Khan","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism Institute, Cleveland Clinic , Cleveland, OH 44195 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"2026052007565794900_luag125-B1"},{"issue":"1","key":"2026052007565794900_luag125-B2","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1002\/PHAR.1014","article-title":"Liraglutide-induced acute kidney injury","volume":"32","author":"Kaakeh","year":"2012","journal-title":"Pharmacotherapy"},{"issue":"2","key":"2026052007565794900_luag125-B3","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1053\/j.ajkd.2013.10.057","article-title":"Acute interstitial nephritis after treatment with liraglutide","volume":"63","author":"Gariani","year":"2014","journal-title":"Am J Kidney Dis Off J Natl Kidney Found"},{"issue":"4","key":"2026052007565794900_luag125-B4","doi-asserted-by":"crossref","first-page":"508","DOI":"10.2337\/cd21-0142","article-title":"A case of dulaglutide-induced acute interstitial nephritis after many years of treatment with an alternate GLP-1 receptor agonist","volume":"40","author":"Komala","year":"2022","journal-title":"Clin Diabetes Publ Am Diabetes Assoc"},{"issue":"12","key":"2026052007565794900_luag125-B5","doi-asserted-by":"crossref","first-page":"100561","DOI":"10.1016\/j.xkme.2022.100561","article-title":"Semaglutide-associated acute interstitial nephritis: a case report","volume":"4","author":"Borkum","year":"2022","journal-title":"Kidney Med"},{"issue":"Supplement_1","key":"2026052007565794900_luag125-B6","doi-asserted-by":"crossref","DOI":"10.1210\/jendso\/bvad114.716","article-title":"THU280 acute interstitial nephritis- A complication of semaglutide use","volume":"7","author":"Alsayed Hasan","year":"2023","journal-title":"J Endocr Soc"},{"key":"2026052007565794900_luag125-B7","first-page":"1","volume-title":"StatPearls","author":"Goyal","year":"2025"},{"issue":"1","key":"2026052007565794900_luag125-B8","first-page":"19","article-title":"Acute kidney injury","volume":"7","author":"Patschan","year":"2015","journal-title":"J Inj Violence Res"},{"issue":"3","key":"2026052007565794900_luag125-B9","first-page":"57","article-title":"Drug-induced renal disorders","volume":"4","author":"Ghane Shahrbaf","year":"2015","journal-title":"J Renal Inj Prev"},{"key":"2026052007565794900_luag125-B10","volume-title":"Interstitial Nephritis (Archived). 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