Adverse effects of drugs on the kidney

Bartoli, Ettore

doi:10.1016/j.ejim.2015.12.001

Cited by 24 publications

(22 citation statements)

References 89 publications

(104 reference statements)

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“…Mild congestion and shrinkage of glomerulus observed in the group treated dihydroartemisinin/piperaquine may indicate renal toxicity. Drugs can exert toxic effect on the glomerulus [31]. As most drugs are excreted by the kidney, it is reasonable to assume that the kidney itself could be a privileged target of their toxic action [31].…”

Section: Discussionmentioning

confidence: 99%

Haematological and Histopathological Effects of Artemisinin-Based Combination Therapy in Healthy Mice

Okafor

Helen

Nwankwo

2020

AJOB

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Artemisinin-based combination therapy had been recommended for the treatment of uncomplicated malaria in Africa. Aim: This study investigated the effects of artesunate/amodiaquine (A/A) and dihydroartemisinin/ piperaquine (D/P) on some blood parameters and histopathology of the liver and kidney of mice. Materials and Methods: A Complete randomized design was applied. Fifty mice were randomly assigned to five treatment groups of ten animals each. Therapeutic doses of the drugs were orally administered to the animals. Group A received normal saline (control), group B received 10/14mg/kg body weight of artesunate/amodiaquine for 3 days, group C received 10/18mg/kg of dihydroartemisinin/piperaquine for 3 days, group D received similar treatment with group B, but were followed up to 28 days, group E received similar treatment with group C but were also followed up to 28 days. After experimental period, blood samples were collected for determination of white blood cell count, white blood cell differential count, red blood cell count, packed cell volume and haemoglobin concentration. Liver and kidney were also harvested for histopathological analysis. Results: Result showed that therapeutic doses of artesunate/amodiaquine and dihydroaretmisinin/ piperaquine had no significant (P>0.05) effects on heamatological parameters accessed. Mild inflammation and degeneration of hepatocyte were observed in the liver of the group treated with D/P while fatty change was found in the group treated with A/A. Venous congestion was observed in the kidney of the group treated with D/P. After 28 days, degeneration of hepatocyte and inflammatory cells were observed in the liver. Shrunken glomerulus was found in the kidney of the group treated with D/P. Conclusion: These drugs are detrimental to the liver and kidney even at therapeutic dose therefore, they should be used with caution.

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Section: Discussionmentioning

confidence: 99%

Haematological and Histopathological Effects of Artemisinin-Based Combination Therapy in Healthy Mice

Okafor

Helen

Nwankwo

2020

AJOB

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“…Notably, there is some evidence indicating pharmacokinetic or pharmacodynamic differences and variability among different various SGLT2 inhibitors. The likelihood of renal‐related adverse events may depend on whether and to what extent the drug is cleared from the body through kidney excretion . It is reported that ~75% of dapagliflozin is eliminated by the renal pathway, while the other 2 SGLT2 inhibitors appear to be less subject to renal clearance (33% of canagliflozin and 54% of empagliflozin) .…”

Section: Discussionmentioning

confidence: 99%

“…The likelihood of renal-related adverse events may depend on whether and to what extent the drug is cleared from the body through kidney excretion. 42 It is reported that~75% of dapagliflozin is eliminated by the renal pathway, while the other 2 SGLT2 inhibitors appear to be less subject to renal clearance (33% of canagliflozin and 54% of empagliflozin). [43][44][45] , will not only provide enough statistical power to determine the renal safety of SGLT2 inhibitors, but also solve the issue of whether or not the renal benefit is a class effect or a specific drug effect.…”

Section: Discussionmentioning

confidence: 99%

Sodium‐glucose co‐transporter‐2 inhibitors and risk of adverse renal outcomes among patients with type 2 diabetes: A network and cumulative meta‐analysis of randomized controlled trials

Tang

Zhang

et al. 2017

Diabetes Obesity Metabolism

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Aim:To compare the associations of individual sodium-glucose co-transporter-2 (SGLT2) inhibitors with adverse renal outcomes in patients with type 2 diabetes mellitus (T2DM).Methods: PubMed, EMBASE, CENTRAL and ClinicalTrials.gov were searched for studies published up to May 24, 2016, without language or date restrictions. Randomized trials that reported at least 1 renal-related adverse outcome in patients with T2DM treated with SGLT2 inhibitors were included. Pairwise and network meta-analyses were carried out to calculate the odds ratios (ORs) with 95% confidence intervals (CIs), and a cumulative meta-analysis was performed to assess the robustness of evidence.Results: In total, we extracted 1334 composite renal events among 39 741 patients from 58 trials, and 511 acute renal impairment/failure events among 36 716 patients from 53 trials.Dapagliflozin was significantly associated with a greater risk of composite renal events than placebo (OR 1.64, 95% CI 1.26-2.13). Empagliflozin seemed to confer a lower risk than placebo (OR 0.63, 95% CI 0.54-0.72), canagliflozin (OR 0.48, 95% CI 0.29-0.82) and dapagliflozin (OR 0.38, 95% CI 0.28-0.51). With regard to acute renal impairment/failure, only empagliflozin was significantly associated with a lower risk than placebo (OR 0.72, 95% CI 0.60-0.86). The cumulative meta-analysis indicated the robustness of our significant findings. Conclusions:The present meta-analysis indicated that dapagliflozin may increase the risk of adverse renal events, while empagliflozin may have a protective effect among patients with T2DM. Further data from large well-conducted randomized controlled trials and a real-world setting are warranted. K E Y W O R D Smeta-analysis, renal outcomes, SGLT2 inhibitor, type 2 diabetes

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“…The protease inhibitor, indinavir, and to a lesser extent atazanavir, is poorly soluble in urine and can potentially cause crystalluria with subsequent interstitial nephritis and, rarely, parenchymal fibrosis ( 150 ). Although some medications, specifically those employed as immunosuppressants, have been associated with diffuse fibrosis and sclerosis secondary to increased expression of TGF-β ( 151 ), direct links between indinavir-mediated fibrosis and TGF-β1 have not been evaluated.…”

Section: Renal Disease and Its Relationship To Haart-mediated Toxicitmentioning

confidence: 99%

The Role of Transforming Growth Factor Beta-1 in the Progression of HIV/AIDS and Development of Non-AIDS-Defining Fibrotic Disorders

et al. 2017

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Even after attainment of sustained viral suppression following implementation of highly active antiretroviral therapy, HIV-infected persons continue to experience persistent, low-grade, systemic inflammation. Among other mechanisms, this appears to result from ongoing microbial translocation from a damaged gastrointestinal tract. This HIV-related chronic inflammatory response is paralleled by counteracting, but only partially effective, biological anti-inflammatory processes. Paradoxically, however, this anti-inflammatory response not only exacerbates immunosuppression but also predisposes for development of non-AIDS-related, non-communicable disorders. With respect to the pathogenesis of both sustained immunosuppression and the increased frequency of non-AIDS-related disorders, the anti-inflammatory/profibrotic cytokine, transforming growth factor-β1 (TGF-β1), which remains persistently elevated in both untreated and virally suppressed HIV-infected persons, may provide a common link. In this context, the current review is focused on two different, albeit related, harmful activities of TGF-β1 in HIV infection. First, on the spectrum of anti-inflammatory/immunosuppressive activities of TGF-β1 and the involvement of this cytokine, derived predominantly from T regulatory cells, in driving disease progression in HIV-infected persons via both non-fibrotic and profibrotic mechanisms. Second, the possible involvement of sustained elevations in circulating and tissue TGF-β1 in the pathogenesis of non-AIDS-defining cardiovascular, hepatic, pulmonary and renal disorders, together with a brief comment on potential TGF-β1-targeted therapeutic strategies.

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Adverse effects of drugs on the kidney

Cited by 24 publications

References 89 publications

Haematological and Histopathological Effects of Artemisinin-Based Combination Therapy in Healthy Mice

Haematological and Histopathological Effects of Artemisinin-Based Combination Therapy in Healthy Mice

Sodium‐glucose co‐transporter‐2 inhibitors and risk of adverse renal outcomes among patients with type 2 diabetes: A network and cumulative meta‐analysis of randomized controlled trials

The Role of Transforming Growth Factor Beta-1 in the Progression of HIV/AIDS and Development of Non-AIDS-Defining Fibrotic Disorders

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