Drug-induced crystal nephropathy: an update

Area of Science:

• Nephrology
• Pharmacology
• Toxicology

Background:

• Medications insoluble in urine can precipitate in renal tubules.
• Intratubular precipitation of drugs or endogenous crystals can cause acute and chronic kidney injury (crystal nephropathy).
• Risk factors include volume depletion, kidney disease, and altered urinary pH.

Purpose of the Study:

• To identify and review medications known to cause crystal nephropathy.
• To highlight recently recognized drugs associated with this condition.

Main Methods:

• Literature review using PubMed, Ovid, and Google Scholar.
• Focused on specific drugs: sulfadiazine, acyclovir, indinavir, triamterene, methotrexate (MTX), orlistat, oral sodium phosphate, and ciprofloxacin.

Main Results:

• Sulfadiazine, acyclovir, indinavir, triamterene, and MTX are established causes of crystal nephropathy.
• Orlistat, ciprofloxacin, and oral sodium phosphate solutions are recently identified contributors.

Conclusions:

• Several medications are confirmed to induce crystal nephropathy.
• Emerging drugs and underlying risk factors necessitate continued vigilance for crystal nephropathy.