Related Experiment Video

Updated: Mar 23, 2026

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
08:35

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

Published on: May 26, 2022

4.4K

Medication-Induced Nephrotoxicity in Older Patients

Sergio Fusco, Sabrina Garasto, Andrea Corsonello1

  • 1Unit of Geriatric Pharmacopidemiology, Italian National Research Centre on Aging, C. da Muoio Piccolo, 87100 Cosenza, Italy. andrea_corsonello@tin.it.

Current Drug Metabolism
|April 7, 2016
PubMed
Abstract

Insights

Medication-induced nephrotoxicity is a significant concern in older adults, particularly those over 75, due to complex medication regimens. Effective prevention requires considering patient factors, medications, and their interactions.

Area of Science:

  • Gerontology
  • Nephrology
  • Pharmacology

Background:

  • Older adults (≥75 years) are highly susceptible to medication-induced nephrotoxicity.
  • Complex polypharmacy regimens increase the risk of adverse drug reactions affecting kidney function.
  • Age-related changes in kidney structure and function predispose older individuals to nephrotoxicity.

Purpose of the Study:

  • To review current evidence on the mechanisms, clinical features, diagnosis, and prevention of medication-induced nephrotoxicity in older populations.
  • To identify knowledge gaps and areas for future research in this critical area.

Main Methods:

  • Comprehensive literature search of PubMed.
  • Inclusion of studies on age-related kidney changes, nephrotoxicity mechanisms, drug metabolism, epidemiology, biomarkers, and prevention strategies.
  • Systematic review of 245 selected papers.

Main Results:

  • Medications can cause nephrotoxicity via multiple mechanisms, with older adults being particularly vulnerable.
  • Creatinine-based estimated glomerular filtration rate (eGFR) has limitations in assessing kidney function in the elderly.
  • Innovative biomarkers for acute kidney injury (AKI) lack standardization and systematic evaluation in older populations.

Conclusions:

  • Medication-induced nephrotoxicity is a major health issue in the elderly.
  • Further research is needed on the impact on functional outcomes, diagnostic reliability, biomarker utility, and prevention strategy effectiveness in older adults.

More Related Videos

Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin07:38

Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin

Published on: May 6, 2018

8.9K
5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat08:50

5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat

Published on: July 3, 2013

24.5K

Related Concept Videos

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
310
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
344
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
314
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
326
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
312
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
797