Related Experiment Video

Updated: Oct 30, 2025

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats
06:38

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats

Published on: March 11, 2016

12.2K

The Mechanism of Drug Nephrotoxicity and the Methods for Preventing Kidney Damage

Ewa Kwiatkowska1, Leszek Domański1, Violetta Dziedziejko2

  • 1Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland.

International Journal of Molecular Sciences
|July 2, 2021
PubMed

Insights

Drug-induced acute kidney injury (AKI) affects millions globally. This review details three mechanisms of drug nephrotoxicity: tubular injury, obstruction, and interstitial nephritis, along with risk factors and prevention strategies.

Area of Science:

  • Nephrology
  • Pharmacology
  • Toxicology

Background:

  • Acute kidney injury (AKI) is a significant global health issue, affecting approximately 13.3% of the world's population annually.
  • Key causes of AKI include sepsis, ischemia, and nephrotoxicity, with drug-induced nephrotoxicity accounting for 19-26% of hospitalized cases.

Purpose of the Study:

  • To elucidate the distinct mechanisms of drug-induced nephrotoxicity.
  • To correlate specific drug classes with particular types of kidney injury.
  • To discuss risk factors and preventive or therapeutic strategies for drug-induced AKI.

Main Methods:

  • Review of existing literature on drug-induced nephrotoxicity.
  • Categorization of nephrotoxic mechanisms into tubular injury, tubular obstruction, and interstitial nephritis.
  • Analysis of dose-dependent and dose-independent pathways.

Main Results:

  • Drug-induced nephrotoxicity occurs via three primary mechanisms: proximal tubular injury/acute tubular necrosis (ATN), tubular obstruction by drug crystals/casts, and interstitial nephritis.
  • Proximal tubular injury and tubular obstruction are typically dose-dependent, while interstitial nephritis is dose-independent.
  • Specific drug groups are associated with each of these injury types.

Conclusions:

  • Understanding the mechanisms of drug-induced AKI is crucial for effective management.
  • Identification of risk factors and implementation of preventive measures can mitigate the incidence of drug nephrotoxicity.
  • Further research into targeted therapies for drug-induced kidney injury is warranted.
Keywords:
acute kidney injuryacute tubular necrosiscasts nephropathyinterstitial nephritisnephrotoxicity

More Related Videos

Nephrotoxin Microinjection in Zebrafish to Model Acute Kidney Injury07:58

Nephrotoxin Microinjection in Zebrafish to Model Acute Kidney Injury

Published on: July 17, 2016

9.0K
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

8.6K

Related Concept Videos

Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
106
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
37
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
204
Enhanced Elimination of Poison01:26

Enhanced Elimination of Poison

Poison can be effectively removed from the gastrointestinal (GI) tract through various decontamination procedures.
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...
653
Drug Elimination by Renal Route: Tubular Reabsorption01:22

Drug Elimination by Renal Route: Tubular Reabsorption

During the process of renal excretion, as the glomerular filtrate progresses to the distal convoluted tubule (DCT), drugs that are highly permeable, lipophilic, and nonionized undergo passive reabsorption from the tubular fluid into the surrounding peritubular capillaries. This reabsorption process restricts their elimination through the kidneys. However, the majority of drugs are either weak acids or weak bases, and their ionization level is dependent on pH. By altering the pH of urine, the...
4.5K
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
94