To the Editor.Ìý I find it disconcerting that diazepam, a drug that has been given to millions of people over a many-year period, should be labeled a nephrotoxin based on one case report that was not confirmed by either rechallenge or biopsy.¹ The authors of this article fail to mention that renal failure with eosinophilia may be the result of atheroemboli,² and that eosinophiluria is a nonspecific finding.³ While their patient did not have other features of atheroembolic disease (none were reported), at least his renal disease did occur after coronary angiography. Atheroembolic renal failure may progress over a period of weeks, and spontaneous improvement of renal function can occur. It is a diagnosis that is difficult to exclude in the absence of a renal biopsy. Given the long and benign track record of diazepam, I believe the odds strongly incriminate the angiographic procedure as the cause