Varenicline induced acute interstitial nephritis in the setting of idiopathic membranous glomerulonephritis
Bibliographic record
Abstract
BACKGROUND: Varenicline is a nicotinic receptor partial agonist indicated for the cessation of smoking. It is regarded as having no or minimal renal toxicity. A single case report has linked it to acute interstitial nephritis. CASE PRESENTATION: A 56 year-old female with a long-standing history of idiopathic membranous glomerulonephritis presented on routine follow-up with an unexpected rise in her serum creatinine from a stable baseline of 225 umol/L to 319 umol/L Biopsy revealed acute interstitial nephritis. There were no preceding clinical events other than the initiation of varenicline therapy three months prior. This was discontinued with no improvement in renal function. A ten week course of prednisone was initiated and creatinine levels returned to baseline. Shortly after prednisone therapy was completed, renal function worsened but the patient declined further immunosuppressive therapy. Exposure to varenicline therapy two years prior had also resulted in a reversible decline in kidney function. CONCLUSION: This is only the second case report to document varenicline-induced acute interstitial nephritis. A careful medication history and renal biopsy were essential in identifying the etiology of the acute kidney injury in this patient with a complex renal history.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".