Recent developments in toxic nephropathy.
Toxic nephropathy is an important cause of reversible renal injury if detected early. Renal damage can be due to several different mechanisms affecting different segments of the nephron, renal microvasculature or interstitium. Clinical signs may not be apparent in the early stages and assessment of renal function should include thorough evaluation of glomerular filtration rate, proximal and distal tubular function. A kidney biopsy may be indicated to establish the cause and effect relationship. The presence of comorbid conditions such as older age, diabetes mellitus, hypertension and congestive heart failure have a significant influence on the patient's ability to recover from the toxic effects. A significant degree of drug-induced renal toxicity is only acceptable if the causative agent is used for the curative treatment of an underlying disease but not if the aim is the palliative or supportive therapy. The decision to reduce the dose or to stop the toxic agent must be based on the ultimate goal of therapy and the patient's baseline health status.
Wali
Ravinder K
RK
Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
Henrich
William L
WL
D000935:Antifungal Agents / Q000009:adverse effects; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects; D016207:Cytokines / Q000009:adverse effects; D004365:Drugs, Chinese Herbal / Q000009:adverse effects; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects; D007372:Interferons / Q000009:adverse effects; D007527:Isoenzymes / Q000037:antagonists & inhibitors; D007674:Kidney Diseases / Q000139:chemically induced* / Q000209:etiology; D008565:Membrane Proteins; D009145:Mushroom Poisoning / Q000150:complications; D011451:Prostaglandin-Endoperoxide Synthases; D012460:Sulfasalazine / Q000009:adverse effects
D000935:Antifungal Agents; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D016207:Cytokines; D004365:Drugs, Chinese Herbal; D016756:Immunoglobulins, Intravenous; D007527:Isoenzymes; D008565:Membrane Proteins; D012460:Sulfasalazine; D007372:Interferons; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases