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Related Experiment Videos

Drug-induced nephrotoxicity.

Gabriel Teixeira Montezuma Sales1, Renato Demarchi Foresto2

  • 1Universidade Federal de São Paulo, São Paulo, SP, Brasil.

Revista Da Associacao Medica Brasileira (1992)
|January 16, 2020
PubMed
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Drug-induced kidney injury is common in critically ill patients. Early diagnosis and management, including reducing drug exposure, are crucial for preventing severe outcomes.

Area of Science:

  • Nephrology
  • Pharmacology
  • Toxicology

Background:

  • Acute kidney injury (AKI) affects up to 60% of critical patients.
  • Drug toxicity is the third leading cause of AKI.
  • Nephrotoxicity encompasses direct or indirect renal damage from medications, presenting as acute renal failure, tubulopathies, or glomerulopathies.

Purpose of the Study:

  • To highlight the common causes and presentations of drug-induced nephrotoxicity.
  • To emphasize the importance of early diagnosis and risk factor identification.
  • To outline foundational treatment strategies for drug-induced kidney injury.

Main Methods:

  • Review of common medications associated with reduced glomerular filtration rate (e.g., NSAIDs, vancomycin, cisplatin).
  • Identification of drugs causing tubulopathies (e.g., amphotericin B, polymyxins) and glomerulopathies (e.g., VEGF inhibitors, bisphosphonates).

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  • Discussion of diagnostic importance, risk factors, and biomarkers for early detection.

    • Main Results:

    • Various drug classes are linked to specific renal injury patterns.
    • Multiple clinical presentations can arise from a single nephrotoxic agent.
    • Early identification of risk factors and biomarkers aids in timely intervention.

    Conclusions:

    • Drug-induced nephrotoxicity is a significant clinical challenge.
    • Early diagnosis and management are essential for patient outcomes.
    • Key management strategies include reducing renal exposure, correcting imbalances, and judicious drug selection.