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Acute and chronic toxic nephropathies.

M M Sanders1, A P Marshall

  • 1Department of Pathology, University of Arkansas, Medical Sciences, Little Rock 72205.

Annals of Clinical and Laboratory Science
|May 1, 1989
PubMed
Summary

Drug-induced kidney diseases, including acute interstitial nephritis and tubular necrosis, are common. Mechanisms of toxic nephropathies from various medications remain poorly understood, requiring further investigation.

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Area of Science:

  • Nephrology
  • Toxicology
  • Pharmacology

Background:

  • Toxic nephropathies present diverse morphological patterns, including glomerulonephritis, vasculitis, tubular necrosis, and tubulointerstitial disease.
  • Acute interstitial nephritis due to hypersensitivity is the most frequent form of drug-induced kidney injury.

Purpose of the Study:

  • To review various types of toxic nephropathies and associated causative agents.
  • To summarize current hypotheses regarding the mechanisms of drug-induced kidney toxicity.

Main Methods:

  • Review of existing literature on drug-induced kidney diseases.
  • Morphological classification of toxic nephropathies.
  • Summary of proposed mechanisms of toxicity for specific drugs.

Main Results:

  • Common toxic nephropathies include acute interstitial nephritis (hypersensitivity), focal segmental glomerulosclerosis and necrotizing angiitis (heroin), membranous glomerulopathy (gold, penicillamine, captopril), thrombotic microangiopathy (mitomycin), and tubular necrosis (cyclosporine A, cisplatin, aminoglycosides, cephalosporins).
  • Mechanisms of toxicity are often unclear but hypotheses exist for cyclosporine A, cisplatin, gold, aminoglycosides, cephalosporins, narcotics, sulfonamides, and methotrexate.

Conclusions:

  • A wide range of drugs can induce kidney damage through various mechanisms.
  • Understanding the mechanisms of drug toxicity is crucial for preventing and treating kidney diseases.

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