Abstract: Objective To provide evidence for clinical use of evolocumab injection and to prevent acute kidney damage. Methods The diagnosis and treatment process and cause of acute kidney injury induced by evolozumab injection in a patient with chronic kidney disease after kidney transplantation were analyzed. Based on literature review, the pathogenesis was discussed. Results A 58-year-old male patient who had received allogeneic renal transplantation was treated with atorvastatin calcium tablets and ezetimibe tablets for coronary heart disease and dyslipidemia. Due to poor efficacy, these tablets were replaced by evolocumab 140 mg for subcutaneous injection, which was used 5 times in 4 months. The serum creatinine increased gradually from 144 μmol·L^-1 before medication to 218 μmol·L^-1. After other factors for kidney injury were excluded, the symptom was considered to be related to evolocumab injection, which was then discontinued. Serum creatinine gradually decreased to 156 μmol·L^-1 54 days after withdrawal. Renal function was stable during follow-up. Conclusion Evolocumab injection may possibly cause acute kidney injury, so clinicians need to monitor the level of serum creatinine and discontinue the drug when necessary.

Key words: Evolocumab, Injection, Acute Kidney Injury, Chronic Kidney Disease after Renal Transplantation, Preprotein Converting Enzyme Subtilisin Kexin 9 Inhibitor(PCSK9i), Adverse Drug Reaction