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Drug-induced renal disorders.

Fatemeh Ghane Shahrbaf1, Farahnak Assadi2

  • 1Department of Pediatrics, Section of Nephrology, Mashhad University of Medical Sciences, Mashhad, Iran.

Journal of Renal Injury Prevention
|October 16, 2015
PubMed
Summary

Drug-induced nephrotoxicity is common in children and patients with existing health issues. Early detection and preventive measures are crucial to avoid severe kidney damage and end-stage renal disease.

Keywords:
Acute tubular necrosisDrugs nephrotoxicityHypersensitivity angeitisInterstitial nephritisThrombotic microangiopathyTubular obstruction

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Area of Science:

  • Nephrology
  • Pharmacology
  • Toxicology

Background:

  • Drug-induced nephrotoxicity is a significant clinical concern, particularly in vulnerable populations like infants, young children, and individuals with pre-existing renal or cardiovascular conditions.
  • Various drugs can precipitate acute kidney injury (AKI), interstitial nephritis, nephrotic syndrome, and electrolyte imbalances through mechanisms affecting glomerular hemodynamics and renal tubular cells.

Purpose of the Study:

  • To highlight the prevalence and mechanisms of drug-induced nephrotoxicity.
  • To emphasize the importance of early detection and preventive strategies in managing drug-related kidney damage.

Main Methods:

  • Review of literature on drug-induced nephrotoxicity.
  • Analysis of risk factors and clinical situations associated with adverse renal events.
  • Identification of preventive measures and therapeutic interventions.

Main Results:

  • Drug-induced nephrotoxicity manifests as AKI, tubulointerstitial disease, and renal scarring.
  • High-risk patient groups include those with intravascular volume depletion, diabetes, heart failure, chronic kidney disease, and sepsis.
  • Certain drugs can alter intraglomerular hemodynamics and cause inflammatory changes in renal tubular cells.

Conclusions:

  • Early identification of drug adverse effects on the kidney is vital to prevent progression to end-stage renal disease.
  • Preventive strategies involve understanding nephrotoxicity mechanisms, identifying patient and drug risks, correcting risk factors, assessing renal function, adjusting dosages, and avoiding nephrotoxic drug combinations.