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An overview of drug-induced acute kidney injury

Neesh Pannu1, Mitra K Nadim

  • 1Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada. npannu@ualberta.ca

Critical Care Medicine
|April 11, 2008
PubMed

Insights

Nephrotoxic drugs in critical illness can cause acute renal failure in 25% of patients. A comprehensive strategy, including monitoring renal function and avoiding nephrotoxins, can prevent this devastating complication.

Area of Science:

  • Nephrology
  • Critical Care Medicine
  • Pharmacology

Background:

  • Critical illness frequently requires multiple medications, increasing the risk of kidney injury.
  • Nephrotoxic drugs are a significant cause of severe acute renal failure in critically ill patients, accounting for up to 25% of cases.
  • Acute tubular necrosis is the predominant form of renal damage from nephrotoxin exposure.

Purpose of the Study:

  • To highlight the preventable nature of drug-induced kidney injury in critical care.
  • To outline a comprehensive strategy for avoiding nephrotoxicity in critically ill patients.

Main Methods:

  • Review of existing literature on nephrotoxicity in critical illness.
  • Identification of key preventative measures and monitoring strategies.

Main Results:

  • Nephrotoxic medications are implicated in a substantial proportion of acute renal failure cases in the ICU.
  • Effective management involves proactive assessment and vigilant monitoring of renal function.

Conclusions:

  • Implementing a comprehensive strategy can significantly reduce the incidence of preventable acute renal failure.
  • Key components include accurate assessment of baseline renal function, avoidance of nephrotoxins, continuous renal function monitoring, and prompt cessation of suspected nephrotoxic agents.

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