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[Clinicobiological study of drug-induced renal diseases]
A Hadj-Aissa1, M Laville, J Couder
1Service d'Exploration Fonctionnelle Rénale, Hôpital Edouard-Herriot, Lyon.
Abstract:
The kidney is the main organ involved in drugs elimination and thereby is particularly liable to their toxic effect. The determination of renal function is thus of importance, before and during treatment with a potentially nephrotoxic drug or during trial of new drugs. In this general review, the main methods to measure renal function are briefly analysed. They consist either of simple dosages in blood and urine which allow to roughly evaluate renal functional value and its variations, or more sophisticated investigations which allow a more precise analysis of various nephron functions: glomerular filtration rate and renal plasma flow with measurement of clearances of exogenous markers, determination of basal or maximal tubular activities. The interest of these specific tests is illustrated by the results of a study performed in patients receiving streptozotocin, an antineoplastic nephrotoxic drug. In conclusion, nephrotoxicity of drugs may be in most cases prevented owing to an accurate knowledge of their pharmacokinetics and of risk factors inherent in patients, and to survey of renal function with suitable methods which may lead to modify drug dosage and/or to choose a therapy considering the own evolution of the disease and the possible occurrence of irreversible renal impairment.
Insights
Monitoring kidney function is crucial when using drugs that can harm the kidneys. Accurate assessment helps prevent drug-induced kidney damage by adjusting dosages and selecting appropriate therapies.
Area of Science:
- Nephrology
- Pharmacology
- Toxicology
Context:
- The kidney plays a primary role in drug elimination, making it susceptible to drug-induced toxicity.
- Assessing renal function is vital before, during, and after treatment with potentially nephrotoxic agents or new drug trials.
Purpose:
- To review and analyze key methods for measuring renal function.
- To highlight the importance of specific tests for evaluating nephron functions, including glomerular filtration rate and tubular activities.
Summary:
- This review analyzes methods for assessing renal function, ranging from simple blood and urine tests to sophisticated clearance measurements and tubular activity assessments.
- A study involving streptozotocin, a nephrotoxic antineoplastic drug, illustrates the utility of these specific tests.
- Effective prevention of drug-induced nephrotoxicity relies on understanding drug pharmacokinetics, patient risk factors, and diligent renal function monitoring.
Impact:
- Accurate renal function assessment enables timely modifications in drug dosage or therapy selection.
- Proactive monitoring can prevent irreversible renal impairment and improve patient outcomes in drug therapy.
- This knowledge aids clinicians in managing patients receiving nephrotoxic medications, optimizing treatment strategies, and minimizing adverse renal effects.