Development of Proteinuria in Patient With Solitary Kidney on Rosuvastatin

BACKGROUND: High-dose rosuvastatin (40 mg) has been associated with transient proteinuria, particularly in patients with severe chronic kidney disease. CASE SUMMARY: We report a 59-year-old woman with a solitary kidney who developed proteinuria while on rosuvastatin 40 mg daily. The reduction of the dose to 10 mg daily led to complete resolution of proteinuria. DISCUSSION: The Food and Drug Administration recommendations advise a dose reduction of rosuvastatin to 10 mg in patients with severe chronic kidney disease, but no guidance exists for individuals with a solitary kidney and preserved renal function. This case suggests that these patients may be at risk of rosuvastatin-associated proteinuria and could benefit from lower doses. TAKE-HOME MESSAGES: Clinicians should use caution when prescribing high-dose rosuvastatin in patients with a solitary kidney. Further study is warranted to clarify whether solitary kidney status independently increases the risk of proteinuria.