Nephrotoxicity
Nephrotoxicity is
and some drugs may affect kidney function in more than one way. Nephrotoxins are substances displaying nephrotoxicity.Nephrotoxicity should not be confused with some medications predominantly excreted by the kidneys needing their dose adjusted for the decreased kidney function (e.g., heparin, lithium).
Types of toxicity
Cardiovascular
- General: vasodilatoragents
- Local: ACE inhibitors, ciclosporin,[3] tacrolimus.[3]
Direct tubular effect
- immunoglobulins, mannitol
- lithium salts, cyclophosphamide, amphotericin B
- Tubular obstruction: sulphonamides, methotrexate, aciclovir, diethylene glycol, triamterene.
Acute interstitial nephritis
Main article : Acute interstitial nephritis
- .
Chronic interstitial nephritis
- Lithium salts
- Ciclosporin[4]
Acute glomerulonephritis
Drug-induced glomerular disease is not common but there are a few drugs that have been implicated. Glomerular lesions occur primarily through immune-mediated pathways rather than through direct drug toxicity.
- Pamidronateare known to cause focal segmental glomerulosclerosis
- Gold salts therapy can cause membranous nephropathy[4]
- Penicillamine
Causes of diabetes insipidus
- Lithium salts
- Amphotericin B—reversible at low doses, irreversible at high doses
- Fluoride
- Demeclocycline
- Foscarnet
Other nephrotoxins
- Lead, Uranium, mercury, and cadmium salts[1]
- Aristolochic acid, found in some plants and in some herbal supplements derived from those plants, has been shown to have nephrotoxic effects on humans.
- Rhubarb contains some nephrotoxins which can cause inflammation of the kidneys in some people.
- Fumaric acid, aka food additive E297
- Orellanine
Diagnosis
Nephrotoxicity is usually monitored through a simple blood test. A decreased
creatinine clearance indicates poor kidney function. In interventional radiology, a patient's creatinine clearance levels are all checked prior to a procedure.[citation needed
]
kidney function, which may be more useful clinically when dealing with patients with early kidney disease. Normal creatinine level is between 80 - 120 μmol/L.[citation needed
]
Etymology
The word nephrotoxicity (]
See also
References
Further reading
- Choudhury, Devasmita; Ahmed, Ziauddin (2006). "Drug-associated renal dysfunction and injury". Nature Clinical Practice Nephrology. 2 (2): 80–91. S2CID 42733127.
- Szeto, CC; Chow, KM (2005). "Nephrotoxicity related to new therapeutic compounds". Renal Failure. 27 (3): 329–33. S2CID 6111262.
| Authority control databases: National |
|---|
