Renal Vulnerability to Drug Toxicity

Perazella, Mark A.

doi:10.2215/cjn.02050309

Cited by 342 publications

(296 citation statements)

References 50 publications

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“…The main feature of the AKI is the reduction of glomerular filtration rate, which results in accumulation of nitrogenous products -urea and serum creatinine -a medical condition called azotemia (16) . Patients with minimal reduction in filtration rate have risk factors for AKI (7) .…”

Section: Implications For Practicementioning

confidence: 99%

“…Toxic AKI involves numerous intrinsic factors, some nonmodifiable, such as high age, gender, hypertension, chronic renal failure, congestive heart failure, multiple myeloma and modifiable factors such as dehydration, medication dosage, hypotension, concomitant use of nephrotoxic drugs, shock and sepsis (7,14,21) .…”

Section: Implications For Practicementioning

confidence: 99%

“…This process involves a mechanism of oxidative damage, alteration in mitochondrial apoptosis and necrosis of proximal tubule cells (2,7) , culminating in renal dysfunction, characterized by imbalance of water and electrolytes and reduced excretion of nitrogenous products of metabolism such as urea and creatinine.…”

Section: Introductionmentioning

confidence: 99%

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Nephrotoxicity Of Polymyxin B: Experimental Study In Cells And Implications For Nursing Practice

Neiva

Borges

Watanabe

et al. 2014

Rev. esc. enferm. USP

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RESUMENEl objetivo del estudio fue caracterizar los mecanismos de daño celular implicado en la fisiopatología de la citotoxicidad de la polimixina B en las células tubulares proximales (LLC-PK1) y discutir las propuestas de intervención de enfermería para identificar a los pacientes de riesgo y considerar la prevención o el tratamiento de la lesión renal aguda nefrotóxica. Corresponde a un estudio experimental cuantitativo in vitro, en el cual las células fueron expuestas a sulfato de polimixina B. La viabilidad celular se determinó por exclusión de los colorantes fluorescentes y el método morfológico con la visualización de cuerpos apoptóticos a la microscopía de fluorescencia. Las células expuestas a polimixina B demostraron reducción de la viabilidad, aumento de célu-las apoptóticas y mayor concentración de la enzima lactato deshidrogenasa. La administración de polimixina B in vitro demostró la necesidad de realizar acciones en la práctica clínica para minimizar los efectos adversos como la nefrotoxicidad. DESCRIPTORESPolimixina B Antibacterianos Lesión renal aguda Células LLC-PK1 Atención de enfermería RESUMOO objetivo do estudo foi caracterizar os mecanismos de lesão celular envolvidos na fisiopatologia da citotoxicidade da polimixina B em células tubulares proximais (LLC-PK1) e discutir as proposições de intervenção do enfermeiro para identificar os pacientes de risco e considerar a prevenção ou o tratamento para lesão renal nefrotóxica. Estudo experimental in vitro, onde as células foram expostas ao sulfato de polimixina B. A viabilidade celular foi determinada pela exclusão dos corantes fluorescentes e o método morfológico com visualização de corpos apoptóticos à microscopia de fluorescência. As células expostas à polimixina B apresentaram redução de viabilidade, aumento do número de células em apoptose e maior concentração da enzima desidrogenase láctea. A administração de polimixina B in vitro demonstrou a necessidade de ações na prática clínica para minimizar os efeitos adversos como a nefrotoxicidade. DESCRITORESPolimixina B Antibacterianos Lesão renal aguda Células LLC-PK1 Cuidados de enfermagem ABSTRACTThe aim of the study was to characterize the cell damage mechanisms involved in the pathophysiology of cytotoxicity of polymyxin B in proximal tubular cells (LLC -PK1) and discuss about the nurses interventions to identify at risk patients and consider prevention or treatment of nephrotoxicity acute kidney injury. This is a quantitative experimental in vitro study, in which the cells were exposed to 375μM polymyxin B sulfate concentration. Cell viability was determined by exclusion of fluorescent dyes and morphological method with visualization of apoptotic bodies for fluorescence microscopy. Cells exposed to polymyxin B showed reduced viability, increased number of apoptotic cells and a higher concentration of the enzyme lactate dehydrogenase. The administration of polymyxin B in vitro showed the need for actions to minimize adverse effects such as nephrotoxicity.

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Section: Implications For Practicementioning

confidence: 99%

Section: Implications For Practicementioning

confidence: 99%

See 1 more Smart Citation

Nephrotoxicity Of Polymyxin B: Experimental Study In Cells And Implications For Nursing Practice

Neiva

Borges

Watanabe

et al. 2014

Rev. esc. enferm. USP

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“…(6) Examples include antibiotics, chemotherapeutic agents, analgesics and immunosuppressants. (7) The cyclophosphamide stands out among the chemotherapeutic drugs. It is a cytostatic agent used in the treatment of neoplastic diseases of solid tumors, lymphomas and other non-neoplastic diseases, such as rheumatoid arthritis and systemic lupus erythematosus.…”

Section: Introductionmentioning

confidence: 99%

Renoprotective effect of the Echinodorus macrophyllus in induced renal injury

Nascimento¹,

Watanabe²,

Fonseca³

et al. 2014

Acta paul. enferm.

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Objective: Evaluating the renoprotective effect of Echinodorus macrophyllus in acute kidney injury induced by cyclophosphamide in rats. Methods: Experimental research with Wistar rats, male adults, distributed into groups, namely: Controladministration of 1.5 ml sodium chloride 0.9% intraperitoneally; Echinodorous -administration of 2g/kg of Echinodorus macrophyllus by gavage for five days; Cyclophosphamide -administration of cyclophosphamide 150mg/kg intraperitoneally; and Cyclosphosphamide + Echinodorus -administration of Echinodorus macrophyllus and cyclophosphamide. Renal function (creatinine clearance) and the oxidative metabolites (peroxides and urinary substances reactive to thiobarbituric acid, thiols in kidney tissue) were evaluated. Results: Preconditioning with Echinodorus macrophyllus elevated the creatinine clearance and reduced the levels of oxidative metabolites. Conclusion: The antioxidant action of Echinodorus macrophyllus has demonstrated renoprotective effects evidenced by the reduction of oxidative stress in acute renal injury induced by cyclophosphamide in rats. ResumoObjetivo: Avaliar o efeito renoprotetor do Echinodorus macrophyllus na lesão renal aguda induzida pela ciclofosfamida em ratos. Métodos: Pesquisa experimental com ratos Wistar, machos e adultos que foram distribuídos nos grupos: Controle -administração de 1,5 ml de cloreto de sódio a 0,9,% por via intraperitoneal, Echinodorousadministração de 2g/kg de Echinodorus macrophyllus por gavagem durante cinco dias, Ciclofosfamida -administração de ciclofosfamida 150mg/kg por via intraperitoneal, Ciclosfofamida + Echinodorusadministração de Echinodorus macrophyllus e ciclofosfamida. Foram avaliados a função renal (clearance de creatinina) e os metabólitos oxidativos (peróxidos e substâncias reativas ao ácido tiobarbitúrico urinários, tióis no tecido renal). Resultados: O pré-condicionamento com Echinodorus macrophyllus elevou o clearance de creatinina e reduziu os níveis dos metabólitos oxidativos. Conclusão: A ação antioxidante do Echinodorus macrophyllus demonstrou efeito renoprotetor evidenciado pela redução do estresse oxidativo na lesão renal aguda induzida pela ciclofosfamida em ratos.

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“…Briefly, the cause of kidney injuries could be classified into categories based on: a) toxicity by drugs and toxins, which leads into a kidney injury state (22), and b) genetic basis, which involves the genes governing the structural features of the glomerular basement membrane (23). Indeed, the structural organization of slit diaphragm and the podocyte foot processes constitute the basis of glomerular selectivity (11)(12), and any change in these features would lead to kidney injury like condition with excessive proteinuria.…”

Section: Introductionmentioning

confidence: 99%

A new outlook towards kidney injuries

Satwekar¹,

Satwekar²

2012

Nat Prec

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Acute and chronic progression of injury to the kidney leads to the failure of the renal system and has become an increasingly important cause of morbidity and mortality. Present diagnosis detects the condition only after irreversible loss of 70 percent of kidney function. Current research is focused only on the clinical manifestations after the kidney injuries and not towards the exact cause of the condition. Here we propose a new outlook- that there is an involvement of a pathogen in the pathogenesis of kidney injuries. Basis for our proposal is given by the similarity of the pathogenesis events occurring between a classical example of hepatitis and kidney injuries. Furthermore, literature regarding the role of early kidney injury biomarkers in innate immunity indicates the involvement of the pathogen. Research in this theme possesses a strong possibility in the development of therapeutic, preventive and management strategies for the acute and chronic kidney injuries.

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Renal Vulnerability to Drug Toxicity

Cited by 342 publications

References 50 publications

Nephrotoxicity Of Polymyxin B: Experimental Study In Cells And Implications For Nursing Practice

Nephrotoxicity Of Polymyxin B: Experimental Study In Cells And Implications For Nursing Practice

Renoprotective effect of the Echinodorus macrophyllus in induced renal injury

A new outlook towards kidney injuries

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