Nephrotoxicity

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Nephrotoxicity is toxicity in the kidneys. It is a poisonous effect of some substances, both toxic chemicals and medications, on kidney function.[1] There are various forms,[2] and some drugs may affect kidney function in more than one way. Nephrotoxins are substances displaying nephrotoxicity.

Nephrotoxicity should not be confused with the fact that some medications are predominantly excreted by the kidneys and need their dose adjusted for the decreased kidney function (e.g., heparin, lithium).

Types of toxicity

Cardiovascular

Direct tubular effect

Acute interstitial nephritis

Main article : Acute interstitial nephritis

Chronic interstitial nephritis

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.

Causes of diabetes insipidus

Other nephrotoxins

Diagnosis

Nephrotoxicity is usually monitored through a simple blood test. A decreased creatinine clearance indicates poor kidney function. Normal creatinine level is between 80 - 120 μmol/L. In interventional radiology, a patient's creatinine clearance levels are all checked prior to a procedure.

Serum creatinine is another measure of kidney function, which may be more useful clinically when dealing with patients with early kidney disease.

Etymology

The word nephrotoxicity (/ˌnɛfrtɒkˈsɪsɪti/) uses combining forms of nephro- + tox- + -icity, yielding "kidney poisoning".

See also

References

  1. ^ a b Abyar, Selda; Khandar, Ali Akbar; Salehi, Roya; Abolfazl Hosseini-Yazdi, Seyed; Alizadeh, Effat; Mahkam, Mehrdad; Jamalpoor, Amer; White, Jonathan M.; Shojaei, Motahhareh; Aizpurua-Olaizola, O.; Masereeuw, Rosalinde (December 2019). "In vitro nephrotoxicity and anticancer potency of newly synthesized cadmium complexes". Scientific Reports. 9 (1): 14686. doi:10.1038/s41598-019-51109-9. ISSN 2045-2322. PMC 6789105. PMID 31604983.
  2. ^ Galley HF (2000). "Can acute renal failure be prevented". J R Coll Surg Edinb. 45 (1): 44–50. PMID 10815380. Archived from the original on 2005-10-18.
  3. ^ a b Naesens M, Kuypers DR, Sarwal M (2009). "Calcineurin inhibitor nephrotoxicity". Clin. J. Am. Soc. Nephrol. 4 (2): 481–509. doi:10.2215/CJN.04800908. PMID 19218475.
  4. ^ a b USMLE WORLD QBanks 2009, Step1, Pharmacology, Q74

Further reading