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Emerging therapy-related kidney disease
1Department of Pathology and Laboratory Medicine, University of Cincinnati Academic Health Center, Cincinnati, Ohio, USA.
Archives of Pathology & Laboratory Medicine
|February 7, 2009
Summary
Newer therapies can cause kidney damage, leading to acute or chronic renal injury. Pathologists identifying these drug-induced renal toxicities can help prevent long-term kidney disease.
Area of Science:
- Nephrology
- Pathology
- Pharmacology
Background:
- Recent advancements in therapeutics have introduced novel treatments for various conditions.
- Several new therapies carry risks of direct or indirect renal toxicity.
- Early detection of drug-induced kidney injury (DIKI) is crucial and relies on pathologist awareness of patient's medication history.
Purpose of the Study:
- To review and discuss patterns of renal injury associated with medications and therapeutic regimens introduced in the last decade.
- To enhance pathologist recognition of DIKI to facilitate timely clinical intervention.
- To prevent further renal function decline and progression to chronic kidney disease.
Main Methods:
- Comprehensive review of recent scientific literature.
- Analysis of unpublished case-derived pathological observations.
Main Results:
- Emergence of numerous novel therapeutic agents as causes of renal toxicity.
- Diverse pathological changes observed in the kidney, including glomerular, tubular, interstitial, and vascular injury.
- Outcomes range from reversible acute injury to irreversible chronic kidney disease and end-stage renal disease.
Conclusions:
- Newer therapies are increasingly recognized as nephrotoxic.
- Pathological patterns of DIKI vary, affecting different kidney compartments.
- Prompt identification and removal of the offending agent can mitigate or reverse kidney damage, preventing chronic kidney disease.
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