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Risk of Acute Kidney Injury Associated With Nephrotoxic Burden in Hospitalized Patients: A Scoping Review
Wafa Alatawi1,2, Jessica L Wallace3, Dhakrit Rungkitwattanakul4
1Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Clinical Pharmacology and Therapeutics
|December 21, 2025
Summary
The cumulative effect of multiple nephrotoxic drugs significantly increases acute kidney injury (AKI) risk. Quantifying this nephrotoxic burden is crucial for clinical decision-making and AKI prevention strategies.
Area of Science:
- Nephrology
- Pharmacology
- Clinical Medicine
Background:
- Limited evidence synthesizes the risk of acute kidney injury (AKI) from multiple nephrotoxic drugs.
- The concept of nephrotoxic burden, representing cumulative drug exposure, requires further definition and quantification.
Conclusions:
- Concomitant exposure to multiple nephrotoxins demonstrably harms the kidney, increasing AKI risk.
- Clinicians and institutions must act to prevent AKI by managing nephrotoxic drug exposure.
- Future research should standardize nephrotoxic burden assessment with drug-specific weighting for better clinical guidance.
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