Polypharmacy is a common feature of the treatment of people with type 2 diabetes. Many patients are receiving treatment for concomitant disorders in addition to glucose lowering therapies. Herein we report a patient with normal renal function on polypharmacy who had exenatide added to his glucose-lowering regimen. When the patient presented with acute renal failure some medications, including exenatide which has been associated with rare cases of renal insufficiency, were discontinued. The patient made a rapid recovery, but the simultaneous withdrawal of several agents precludes ascribing causal effect to a single drug. Nevertheless withdrawal of agents metabolised or eliminated via the kidney is warranted in renal failure.
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