Drug-induced nephrotoxicity

Authors

  • Dinesh K. Dhodi Department of Pharmacology, Grant Government Medical College & Sir JJ Group of Hospital, Byculla, Mumbai, Maharashtra, India
  • Sagar B. Bhagat Department of Pharmacology, Grant Government Medical College & Sir JJ Group of Hospital, Byculla, Mumbai, Maharashtra, India
  • Deepanjali Pathak Department of Pharmacology, Grant Government Medical College & Sir JJ Group of Hospital, Byculla, Mumbai, Maharashtra, India
  • Sadiq B. Patel Department of Pharmacology, Grant Government Medical College & Sir JJ Group of Hospital, Byculla, Mumbai, Maharashtra, India

Keywords:

Medications, Nephrotoxicity, Pharmacovigilance, Renal biomarkers, Renal failure

Abstract

Drug-induced nephrotoxicity is an extremely common condition and is responsible for a variety of pathological effects on the kidneys. Drug-induced acute renal failure (ARF) accounted for 20% of all ARF cases. Drugs showed to cause nephrotoxicity exert their toxic effects by one or more common pathogenic mechanisms. Although it is impossible to present all the drugs causing the nephrotoxicity, this article will summarize the mechanism of injury associated with particular common medications, discuss clinical presentations, renal markers, and evaluate strategies that prevent or minimize renal injury. Drug-induced nephrotoxicity tends to be more common among certain patients and in specific clinical situations. Therefore, successful prevention requires knowledge of pathogenic mechanisms of renal injury, patient-related risk factors, drug-related risk factors, and preemptive measures, coupled with vigilance and early intervention. General preventive measures include using alternative non-nephrotoxic drugs whenever possible; correcting risk factors, if possible; assessing baseline renal function before initiation of therapy, followed by adjusting the dosage; monitoring renal function and vital signs during therapy, and avoiding nephrotoxic drug combinations. Surprisingly, little information is available to guide us with respect to avoiding complications in critical illness; therefore, it is necessary to follow the guidelines.

References

Asangansi IE, Oshin AO, Akinloye AO. Drug nephrotoxicity. Ifemed J Med. 2005; Available at http://www.imeasangansi.org/pdf/drug%20nephrotoxicity.pdf. [Accessed 2014 May 25].

Laurie B, Nghiem HT. Recommendations Issued for Preventing Drug-Induced Nephrotoxicity. Medscape Medical News, 2008. Available from: http://www.medscape.org/viewarticle/581271. [Last cited on 2013 Jun 15].

Jha V, Chugh KS. Drug induced renal disease. J Assoc Physicians India. 1995;43(6):407-21.

Singh NP, Ganguli A, Prakash A. Drug-induced kidney diseases. J Assoc Physicians India. 2003;51:970-9.

Perazella MA. Drug-induced nephropathy: an update. Expert Opin Drug Saf. 2005;4(4):689-706.

Gambaro G, Perazella MA. Adverse renal effects of anti-inflammatory agents: evaluation of selective and nonselective cyclooxygenase inhibitors. J Intern Med. 2003;253(6):643-52.

Naughton CA. Drug-induced nephrotoxicity. Am Fam Physician. 2008;78(6):743-50.

Luft FC. Clinical significance of renal changes engendered by aminoglycosides in man. J Antimicrob Chemother. 1984;13 Suppl A:23-30.

Gilbert DN. Once-daily aminoglycoside therapy. Antimicrob Agents Chemother. 1991;35(3):399-405.

Briguori C, Colombo A, Airoldi F, Morici N, Sangiorgi GM, Violante A, et al. Nephrotoxicity of low-osmolality versus iso-osmolality contrast agents: impact of N-acetylcysteine. Kidney Int. 2005;68(5):2250-5.

Ergün I, Keven K, Uruç I, Ekmekçi Y, Canbakan B, Erden I, et al. The safety of gadolinium in patients with stage 3 and 4 renal failure. Nephrol Dial Transplant. 2006;21(3):697-700.

Isnard Bagnis C, Deray G, Baumelou A, Le Quintrec M, Vanherweghem JL. Herbs and the kidney. Am J Kidney Dis. 2004;44(1):1-11.

Wang IJ, Chen PC, Hwang KC. Melamine and nephrolithiasis in children in Taiwan. N Engl J Med. 2009;360(11):1157-8.

Van Vleet TR, Schnellmann RG. Toxic nephropathy: environmental chemicals. Semin Nephrol. 2003;23(5):500-8.

Brewster UC, Perazella MA. A review of chronic lead intoxication: an unrecognized cause of chronic kidney disease. Am J Med Sci. 2004;327(6):341-7.

Yu CC, Lin JL, Lin-Tan DT. Environmental exposure to lead and progression of chronic renal diseases: a four-year prospective longitudinal study. J Am Soc Nephrol. 2004;15(4):1016-22.

Yao X, Panichpisal K, Kurtzman N, Nugent K. Cisplatin nephrotoxicity: a review. Am J Med Sci. 2007;334(2):115-24.

Farber BF, Moellering RC Jr. Retrospective study of the toxicity of preparations of vancomycin from 1974 to 1981. Antimicrob Agents Chemother. 1983;23(1):138-41.

Sorrell TC, Collignon PJ. A prospective study of adverse reactions associated with vancomycin therapy. J Antimicrob Chemother. 1985;16(2):235-41.

Palmer BF. Renal dysfunction complicating the treatment of hypertension. N Engl J Med. 2002;347(16):1256-61.

Schetz M, Dasta J, Goldstein S, Golper T. Drug-induced acute kidney injury. Curr Opin Crit Care. 2005;11(6):555-65.

Guo X, Nzerue C. How to prevent, recognize, and treat drug-induced nephrotoxicity. Cleve Clin J Med. 2002;69(4):289-90, 293.

Fuchs TC, Hewitt P. Biomarkers for drug-induced renal damage and nephrotoxicity-an overview for applied toxicology. AAPS J. 2011;13(4):615-31.

Choudhury D, Ahmed Z. Drug-associated renal dysfunction and injury. Nat Clin Pract Nephrol. 2006;2(2):80-91.

Gurwitz JH, Field TS, Harrold LR, Rothschild J, Debellis K, Seger AC, et al. Incidence and preventability of adverse drug events among older persons in the ambulatory setting. JAMA. 2003;289(9):1107-16.

Kaufman J, Dhakal M, Patel B, Hamburger R. Community-acquired acute renal failure. Am J Kidney Dis. 1991;17(2):191-8.

Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis. 2002;39(5):930-6.

Schoolwerth AC, Sica DA, Ballermann BJ, Wilcox CS, Council on the Kidney in Cardiovascular Disease and the Council for High Blood Pressure Research of the American Heart Association. Renal considerations in angiotensin converting enzyme inhibitor therapy: a statement for healthcare professionals from the Council on the Kidney in Cardiovascular Disease and the Council for High Blood Pressure Research of the American Heart Association. Circulation. 2001;104(16):1985-91.

Fry AC, Farrington K. Management of acute renal failure. Postgrad Med J. 2006;82(964):106-16.

Downloads

Published

2017-01-25

How to Cite

Dhodi, D. K., Bhagat, S. B., Pathak, D., & Patel, S. B. (2017). Drug-induced nephrotoxicity. International Journal of Basic & Clinical Pharmacology, 3(4), 591–597. Retrieved from https://www.ijbcp.com/index.php/ijbcp/article/view/1036

Issue

Section

Review Articles