{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:25:50Z","timestamp":1792790750571,"version":"4.5.0"},"reference-count":165,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:00:00Z","timestamp":1688947200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Mayo Clinic"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Unlike other adverse drug reactions, visceral organ involvement is a prominent feature of drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome and correlates with mortality. The aim of this study was to systematically review cases published in PubMed-indexed, peer-reviewed journals in which patients had renal injury during the episode of DRESS syndrome (DS). We found 71 cases, of which 67 were adults and 56% were males. Female sex was associated with higher mortality. Chronic kidney disease (CKD) was present in 14% of patients who developed acute kidney injury (AKI) during DS. In 21% of cases, the kidneys were the only visceral organ involved, while 54% of patients had both liver and kidney involvement. Eosinophilia was absent in 24% of patients. The most common classes of medication associated with renal injury in DS were antibiotics in 34%, xanthine oxidase inhibitors in 15%, and anticonvulsants in 11%. Among antibiotics, vancomycin was the most common culprit in 68% of patients. AKI was the most common renal manifestation reported in 96% of cases, while isolated proteinuria or hematuria was present in only 4% of cases. In cases with AKI, 88% had isolated increase in creatinine and decrease in glomerular filtration (GFR), 27% had AKI concomitantly with proteinuria, 18% had oliguria, and 13% had concomitant AKI with hematuria. Anuria was the rarest manifestation, occurring in only 4% of patients with DS. Temporary renal replacement therapy was needed in 30% of cases, and all but one patient fully recovered renal function. Mortality of DS in this cohort was 13%, which is higher than previously reported. Medication class, latency period, or pre-existing CKD were not found to be associated with higher mortality. More research, particularly prospective studies, is needed to better recognize the risks associated with renal injury in patients with DS. The development of disease-specific biomarkers would also be useful so DS with renal involvement can be easier distinguished from other eosinophilic diseases that might affect the kidney.<\/jats:p>","DOI":"10.3390\/jcm12144576","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:54:23Z","timestamp":1688950463000},"page":"4576","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Renal Manifestations of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome: A Systematic Review of 71 Cases"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2729-4861","authenticated-orcid":false,"given":"Marilia","family":"Dagnon da Silva","sequence":"first","affiliation":[{"name":"Municipal University of S\u00e3o Caetano do Sul\u2014USCS Bela Vista, S\u00e3o Paulo 09521-160, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7702-3567","authenticated-orcid":false,"given":"Sidney Marcel","family":"Domingues","sequence":"additional","affiliation":[{"name":"Municipal University of S\u00e3o Caetano do Sul\u2014USCS Bela Vista, S\u00e3o Paulo 09521-160, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3570-8960","authenticated-orcid":false,"given":"Stevan","family":"Oluic","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Loyola University Medical Center, Maywood, IL 60402, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9692-8772","authenticated-orcid":false,"given":"Milan","family":"Radovanovic","sequence":"additional","affiliation":[{"name":"Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA"},{"name":"Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratyusha","family":"Kodela","sequence":"additional","affiliation":[{"name":"Mayo Clinic Health System, Eau Claire, WI 54703, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7529-1334","authenticated-orcid":false,"given":"Terri","family":"Nordin","sequence":"additional","affiliation":[{"name":"Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA"},{"name":"Department of Family Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret R.","family":"Paulson","sequence":"additional","affiliation":[{"name":"Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA"},{"name":"Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3794-2539","authenticated-orcid":false,"given":"Bojan","family":"Joksimovi\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Foca, University of East Sarajevo, 73300 Foca, The Republic of Srpska, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omobolanle","family":"Adetimehin","sequence":"additional","affiliation":[{"name":"Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA"},{"name":"Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devender","family":"Singh","sequence":"additional","affiliation":[{"name":"Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA"},{"name":"Department of Nephrology, Mayo Clinic Health System, Eau Claire, WI 54703, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Madrid","sequence":"additional","affiliation":[{"name":"Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA"},{"name":"Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2656-7198","authenticated-orcid":false,"given":"Milena","family":"Cardozo","sequence":"additional","affiliation":[{"name":"Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA"},{"name":"Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5585-9793","authenticated-orcid":false,"given":"Marko","family":"Baralic","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Clinical Center of Serbia, 11000 Belgrade, Serbia"},{"name":"School of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5312-8812","authenticated-orcid":false,"given":"Igor","family":"Dumic","sequence":"additional","affiliation":[{"name":"Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA"},{"name":"Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/S1085-5629(96)80038-1","article-title":"Drug-induced pseudolymphoma and drug hypersensitivity syndrome (Drug Rash with Eosinophilia and Systemic Symptoms: DRESS)","volume":"15","author":"Bocquet","year":"1996","journal-title":"Semin. 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