Drug-induced nephrotoxicity

Eunjin Bae; Tae Won Lee; Dong Jun Park

doi:10.5124/jkma.2020.63.1.30

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Bae, Lee, and Park: Drug-induced nephrotoxicity

Focused Issue of This Month

Kidney and systemic disease

Journal of the Korean Medical Association 2020; 63(1): 30-35.

Published online: 10 January 2020

DOI: https://doi.org/10.5124/jkma.2020.63.1.30

Drug-induced nephrotoxicity

Eunjin Bae, MD^1,^2,³

, Tae Won Lee, MD¹

, Dong Jun Park, MD^1,^2,³

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 4 October 2019 Accepted 13 December 2019

Korean Medical Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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

Figures and Tables

Table 1

Drugs associated with nephrotoxicity according to pathogenic mechanisms

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

Information from references [10 12 36].

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

Notes

^{Conflict of Interest} No potential conflict of interest relevant to this article was reported.

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ORCID iDs

Eunjin Bae
https://orcid.org/0000-0001-6890-4725

Tae Won Lee
https://orcid.org/0000-0003-1758-3217

Dong Jun Park
https://orcid.org/0000-0001-5233-537X

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