Supplementary Material for: L-Glutamine induced acute kidney injury; a clinical observation.

Introduction: L-Glutamine is increasingly used as a dietary supplement and its use is, as is the case with other amino acids, considered safe. L-Glutamine is the most abundant amino acid in the human body and is involved in many metabolic reactions. Within the kidney L-Glutamine has an important role in the generation of ammonia and bicarbonate. Case presentation: We report a case of acute kidney injury (AKI) as a result of tubular damage in a patient who used 18 grams of L-glutamine on a daily basis. Possible mechanisms are proposed of which increased single nephron ammonia production and toxicity seems most likely cause of AKI. Conclusion: We advise cautious use of L-Glutamine supplements in elderly patient with an already compromised kidney function.