Renal toxicity of therapeutic drugs

Abstract

A number of therapeutic agents can adversely affect the kidney, resulting in tubulointerstitial, glomerular or vascular disease. Drug-induced tubulointerstitial nephritis and acute tubular necrosis are common, and are often cause by antibiotics or non-steroidal anti-inflammatory drugs. Drug-induced glomerular and vascular disease is relatively rare. This review describes the morphological patterns of drug-induced disease in the kidney. The histopathological changes are often similar to disease that is idiopathic or due to other causes, so that awareness and clinical correlation are most helpful to arrive at the aetiology.

Nefrotoxicidade dos anti-inflamatórios não esteroidais

“…12 Sendo assim, qualquer droga que cair na circulação sanguínea e tiver excreção renal passará pelos rins. Pode-se inferir, portanto, que altas concentrações de uma determinada droga na luz dos túbulos renais podem perfeitamente desencadear respostas inflamatórias e comprometer a função de filtração glomerular.…”

“…8 A necrose tubular aguda (NTA) pode ser definida como um dano às células tubulares, causando IRA, na ausência de uma patologia vascular ou glomerular significante. 12 A NTA têm sido relacionada ao uso de fenoprofeno, ibuprofeno e fenilbutazona. 1 Inicialmente, a síndrome renal induzida pelos AINEs apresenta-se com níveis séricos elevados de uréia, creatinina e potássio, e com uma produção de urina reduzida (oligúria).…”

Protective effect of indomethacin in renal ischemia-reperfusion injury in mice

“…For decades, non-steroidal antiinflammatory drugs (NSAIDs) have been used successfully in the treatment of numerous clinical diseases for their anti-inflammatory and analgesic effects. Despite the efficacy, long-term use of NSAIDs could cause renal damage, such as renal papillary necrosis (John and Herzenberg, 2009). Does the short-term and low-dose application of NSAIDs have the same damage, such as patient-controlled analgesia (PCA)?…”

Acute Kidney Injury (AKI) and Management of Renal Tumors

“…ATN is defined by AKI and tubular damage in the absence of significant glomerular or vascular pathology [John, Herzenberg 2009]. The presentation of ATN is a sudden rise of serum creatinine, sometimes with microscopic hematuria and small amounts of proteinuria.…”