title: The 6R's of drug induced nephrotoxicity.
abstract: Drug induced kidney injury is a frequent adverse event which contributes to morbidity and increased healthcare utilization. Our current knowledge of drug induced kidney disease is limited due to varying definitions of kidney injury, incomplete assessment of concurrent risk factors and lack of long term outcome reporting. Electronic surveillance presents a powerful tool to identify susceptible populations, improve recognition of events and provide decision support on preventative strategies or early intervention in the case of injury. Research in the area of biomarkers for detecting kidney injury and genetic predisposition for this adverse event will enhance detection of injury, identify those susceptible to injury and likely mitigate risk. In this review we will present a 6R framework to identify and mange drug induced kidney injury - risk, recognition, response, renal support, rehabilitation and research.
authors.affiliation: UC San Diego Skaggs School of Pharmacy, San Diego, USA. lawdishu@ucsd.edu.|UC San Diego School of Medicine, 9500 Gilman Dr, La Jolla, CA, 92093, USA. lawdishu@ucsd.edu.
authors.forename: Linda
authors.identifier: 0000-0002-3187-3264
authors.initials: L
authors.lastname: Awdishu
authors.affiliation: UC San Diego School of Medicine, 9500 Gilman Dr, La Jolla, CA, 92093, USA.
authors.forename: Ravindra L
authors.initials: RL
authors.lastname: Mehta
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D035843:Biomedical Research; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D017582:Renal Replacement Therapy; D018570:Risk Assessment; D012720:Severity of Illness Index
keywords: Acute kidney injury; Adverse reaction; Crystalluria; Drugs; Glomerular; Hypersensitivity; Nephrolithiasis; Nephrotoxicity; Tubular toxicity