Adoptive immunotherapy with recombinant interleukin-2 has been complicated by significant nephrotoxicity of uncertain etiology. Creatinine clearance, effective renal plasma flow, plasma renin activity, aldosterone levels, and urinary prostaglandin excretion were evaluated in a 62-year-old man receiving continuous infusion recombinant interleukin-2. There was a marked decrease in the creatinine clearance and renal plasma flow, accompanied by an elevation in plasma renin activity and aldosterone level. Prostaglandin excretion also decreased, implying a direct effect on renal prostaglandin synthesis. The decrease in renal prostaglandin synthesis at a time of increased plasma renin activity may explain the reduction in renal function seen with recombinant interleukin-2 therapy.
Bibliographical noteFunding Information:
From the Deparment of Medicine and the Immun-obiology Research Center, University of Minnesota Medical School and the Masonic Cancer Center, Mineapolis, Minnesota. This work was supported in part by General Clinical Research Center Grant RR-00400 from the Division of Research Resources, National Institutes of Health, and grants from the Minnesota Medical Foundation and the Masonic Memorial Hospital Fund, Inc. A portion of this work was presented at the American Association for Cancer Research, New Orleans, May 26, 1988. Requests for reprints should be sent to Dr. Neal P. Christiansen, Box 286, University of Minnesota Hospital and Clinic, Harvard Street at East River Road, Minneapolis, Minnesota 55455. Manuscript submitted December 11, 1987, and accepted in revised form April 13, 1988.