Evaluation of kidney damage that may occur in acne vulgaris patients receiving systemic isotretinoin therapy

Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. It can be seen with a frequency of up to 85% in adolescents and young adults. Systemic isotretinoin is a highly effective drug that has been used for a long time in the treatment of moderate-to-severe acne vulgaris unresponsive to conventional therapy. Besides being effective, it also has many side effects. İn a few case reports that emphasized the side effects of isotretinoin on the kidney that has been reported that it can cause renal failure, nephrotic syndrome, tubulointerstitial nephritis and hematuria. In this study; We aimed to evaluate clinical or subclinical kidney damage in patients using systemic isotretinoin with the diagnosis of acne vulgaris, using early kidney damage markers in addition to routine laboratory findings. In our study, fourty four acne vulgaris patients using systemic isotretinoin were followed for 4 months. 68.2% (n=30) of the patients were female and 31.8% (n=14) were male. At the beginning of the treatment and at the end of the 4th month, liver function tests, lipid panel, urea, creatinine, glomerular filtration rate (GFR), complete urinalysis, albumin/creatinine ratio in spot urine, protein/creatinine ratio in spot urine, urinary kidney damage molecule-1 (uKIM-1), urinary neutrophil gelatinase-associated lipocalin (uNGAL) and urinary beta 2-microglobulin (uB2M) levels were compared. It was determined that aspartate aminotransferase, triglyceride, total cholesterol, low-density lipoprotein and very low-density lipoprotein levels of the patients increased after the treatment and this increment was statistically significant. It was determined that there was a statistically significant decrease in high-density lipoprotein level. There was no statistically significant difference in the urea, creatinine, GFR, complete urinalysis, spot urine protein/creatinine and albumin/creatinine ratios of the patients. It was determined that urea and creatinine levels were higher in males than females before and after treatment, and this difference was statistically significant. It was determined that the ratio of albumin/creatinine in the spot urine was significantly higher in women before and after treatment compared to men. There was no statistically significant difference in the uKIM-1, uKIM-1/creatinine, uNGAL, uNGAL/creatinine, uB2M and uB2M/creatinine values of the patients before and after the treatment. There was no statistically significant difference in uKIM-1, uNGAL and uB2M values between male and female patients before treatment. There was no statistically significant difference in uKIM-1 and uNGAL values between male and female patients after treatment. After the treatment, it was determined that the uB2M value was statistically higher significant in men than in women. There was no statistically significant difference in uKIM-1/creatinine, uNGAL/creatinine and uB2M/creatinine values between male and female patients before and after treatment. In conclusion, the data obtained from our study shows that systemic isotretinoin used in patients with acne vulgaris does not cause kidney damage and is a drug that can be used safely.