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J Korean Med Assoc > Volume 63(1); 2020 > Article
Bae, Lee, and Park: Drug-induced nephrotoxicity

Abstract

Drugs are a common cause of acute and chronic kidney disease and contribute to patient morbidity and increased healthcare utilization. Drug-induced nephrotoxicity is approximately 14% to 26% in adults and tends to increase among certain patients and/or with complex clinical conditions. Unfortunately, apart from conservative management, including drug withdrawal, no effective treatment is known for this condition. Therefore, in order to reduce the frequency of drug-induced nephrotoxicity, early recognition of renal toxicity and appropriate prevention strategies, such as understanding the exact mechanisms of renal injury, patient and drug-related risk factors, and preemptive measures are needed. In this review, we will present the mechanisms of drug-induced nephrotoxicity and general preventive strategies for clinical physicians.

Notes

No potential conflict of interest relevant to this article was reported.

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Table 1

Drugs associated with nephrotoxicity according to pathogenic mechanisms

jkma-63-30-i001.jpg

Information from references [4,10,11,12].

NSAID, nonsteroidal anti-inflammatory drug; ACE, angiotensin-converting enzyme; ARB, angiotensin receptor blockers; COX-2, cyclooxygenase-2; IVIG, intravenous immune globulin.

Table 2

General preventive strategies to prevent drug-induced nephrotoxicity

jkma-63-30-i002.jpg

Information from references [10,12,36].

MDRD, Modification of Diet in Renal Disease; CG, Cockcroft and Gault; eGFR, estimated glomerular filtration rate.

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