Antiviral drug-induced nephrotoxicity

Area of Science:

• Nephrology
• Pharmacology
• Toxicology

Background:

• Drug-induced kidney injury is a significant clinical issue, contributing to 2-15% of acute renal failure cases.
• Antiviral medications pose a risk for nephrotoxicity through various mechanisms.
• The precise incidence of antiviral drug-induced kidney injury remains challenging to quantify.

Purpose of the Study:

• To review the pathogenesis of kidney injury caused by antiviral drugs.
• To identify common nephrotoxic renal syndromes associated with antiviral use.
• To discuss strategies for preventing antiviral drug-induced kidney injury.

Main Methods:

• Review of existing literature on antiviral drug nephrotoxicity.
• Analysis of mechanisms including direct tubular toxicity and crystal nephropathy.
• Identification of specific antiviral agents implicated in kidney injury.

Main Results:

• Antiviral drugs induce kidney injury via direct tubular toxicity (e.g., cidofovir, tenofovir, acyclovir) and crystal deposition (e.g., acyclovir, indinavir).
• Mechanisms involve damage to renal tubular epithelial cells and interference with renal transporters.
• Diverse pathological processes contribute to antiviral-associated renal syndromes.

Conclusions:

• Antiviral drug-induced kidney injury is multifactorial, involving direct cellular damage and crystal formation.
• Recognizing specific nephrotoxic agents and their mechanisms is crucial for clinical management.
• Proactive strategies are necessary to mitigate the risk of kidney injury in patients receiving antiviral therapy.