Emerging therapy-related kidney disease.
BACKGROUND
Many new therapies have emerged within the last 5 to 10 years to treat a variety of conditions. Several of these have direct or indirect renal toxicities that may go undiagnosed without careful attention of the pathologist to a patient's clinical history, particularly the addition of new medications or treatments.


OBJECTIVE
To discuss patterns of renal injury resulting from medications or therapeutic regimens that have been introduced within the last 10 years. Recognition of these patterns may allow the pathologist to alert the attending clinician to a possible drug-induced renal injury and prevent further deterioration of renal function and possible chronic kidney disease.


METHODS
A review of recent literature and unpublished observations of case-derived material.


CONCLUSIONS
A number of newer therapies have emerged as agents of renal toxicity, producing a variety of pathologic changes in the kidney. The outcome can be acute or chronic glomerular, tubular, interstitial, and/or vascular injury. Some drugs will result in irreversible changes and end-stage renal disease, whereas many of the alterations can be reversed with removal of the offending agent, avoiding potential long-term kidney injury.
Arend
Lois J
LJ
Department of Pathology and Laboratory Medicine, University of Cincinnati Academic Health Center, Cincinnati, Ohio, USA.
Nadasdy
Tibor
T
D001706:Biopsy; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology*; D007678:Kidney Glomerulus / Q000473:pathology; D007684:Kidney Tubules / Q000473:pathology