Renal Repercussions of Medications

Medications are a common cause of acute kidney injury and chronic kidney disease. Older patients with multiple comorbidities and polypharmacy are at increased risk and require extra diligence. Antimicrobials, antihypertensives, and nonsteroidal anti-inflammatory drugs are common offenders of drug-induced kidney injury. Other drug classes that can cause kidney damage include immunosuppressive medications, statins, proton pump inhibitors, and herbal supplements. Awareness of such medications and their mechanisms of nephrotoxicity helps decrease morbidity and mortality. If nephrotoxic agents cannot be avoided, hydration, avoiding concomitant nephrotoxic medications, and using the lowest effective dose for the shortest duration are strategies that can decrease risk of kidney damage.