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Drug-induced nephrotoxicity

Article information

J Korean Med Assoc. 2020;63(1):30-35
Publication date (electronic) : 2020 January 10
doi : https://doi.org/10.5124/jkma.2020.63.1.30
Eunjin Bae, MD1,2,3orcid_icon, Tae Won Lee, MD1orcid_icon, Dong Jun Park, MD1,2,3orcid_icon
1Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Jinju, Korea.
2Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Korea.
3Institute of Health Science, Gyeongsang National University, Jinju, Korea.
Corresponding author: Dong Jun Park. drpdj@gnuh.co.kr
Received 2019 October 04; Accepted 2019 December 13.

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.

Keywords: Glomerulus; Kidney tubules; Renal insufficiency; Pharmaceutical preparations; Toxicity

Notes

Conflict of Interest

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

Table 1

Information from references [4101112].

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

Table 2

Information from references [101236].

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