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Nephrotoxicity

Encyclopedia : N : NE : NEP : Nephrotoxicity

Nephrotoxicity is a poisonous effect of some substances, both toxic substances and medication, on the kidney. There are various forms of toxicity^{[#endnote_RCSED-AFR-Prevention]}. It should not be confused with the fact that some medications have a predominantly renal excretion and need their dose adjusted for the decreased renal function (e.g. heparin).

Nephrotoxins are chemicals displaying nephrotoxicity.

The nephrotoxic effect of most drugs is more profound in patients who already have renal impairment. Some drugs may affect renal function in more than one way.

Contents

1 Types of toxicity

1.1 Cardiovascular
1.2 Direct tubular effect
1.3 Acute interstitial
1.4 Acute glomerulonephritis
1.5 Causes of

2 References
3 See also

Types of toxicity

Cardiovascular

General: diuretics, β-blockers, vasodilator agents
Local: ACE inhibitors, ciclosporin

Direct tubular effect

Proximal convoluted tubule: Aminoglycoside antibiotics (e.g. gentamicin), amphotericin B, cisplatin, radiocontrast media, immunoglobulins, mannitol
Distal tubule: NSAIDs (eg aspirin, ibuprofen, diclofenac), ACE inhibitors, ciclosporin, lithium salts, cyclophosphamide, amphotericin B
Tubular obstruction: sulphonamides, methotrexate, aciclovir, polyethylene glycol

Acute interstitial
β-lactam antibiotics, vancomycin, rifampicin, sulphonamides, ciprofloxacin, NSAIDs, ranitidine, cimetidine, furosemide, thiazides, phenytoin

Acute glomerulonephritis

penicillamine

Causes of
lithium salts
amphotericin B
fluoride
demeclocycline
foscarnet

References

↑ Galley HF. Can acute renal failure be prevented? J R Coll Surg Edinb 2000;45(1):44-50. [Fulltext]. PMID 10815380.

See also

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