The Mechanism of Drug Nephrotoxicity and the Methods for Preventing Kidney Damage
Acute kidney injury (AKI) is a global health challenge of vast proportions, as approx. 13.3% of people worldwide are affected annually. The pathophysiology of AKI is very complex, but its main causes are sepsis, ischemia, and nephrotoxicity. Nephrotoxicity is mainly associated with the use of drugs....
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doaj-d979a55702ac4df8b71535c5def33d452021-06-30T23:26:03ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672021-06-01226109610910.3390/ijms22116109The Mechanism of Drug Nephrotoxicity and the Methods for Preventing Kidney DamageEwa Kwiatkowska0Leszek Domański1Violetta Dziedziejko2Anna Kajdy3Katarzyna Stefańska4Sebastian Kwiatkowski5Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, PolandClinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, PolandDepartment of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-111 Szczecin, PolandCentre of Postgraduate Medical Education, Department of Reproductive Health, St. Sophie’s Obstetrics and Gynecology Hospital, 01-004 Warsaw, PolandDepartment of Obstetrics Medical, University of Gdańsk, 80-952 Gdańsk, PolandDepartment of Obstetrics and Gynecology, Pomeranian Medical University, 70-111 Szczecin, PolandAcute kidney injury (AKI) is a global health challenge of vast proportions, as approx. 13.3% of people worldwide are affected annually. The pathophysiology of AKI is very complex, but its main causes are sepsis, ischemia, and nephrotoxicity. Nephrotoxicity is mainly associated with the use of drugs. Drug-induced AKI accounts for 19–26% of all hospitalized cases. Drug-induced nephrotoxicity develops according to one of the three mechanisms: (1) proximal tubular injury and acute tubular necrosis (ATN) (a dose-dependent mechanism), where the cause is related to apical contact with drugs or their metabolites, the transport of drugs and their metabolites from the apical surface, and the secretion of drugs from the basolateral surface into the tubular lumen; (2) tubular obstruction by crystals or casts containing drugs and their metabolites (a dose-dependent mechanism); (3) interstitial nephritis induced by drugs and their metabolites (a dose-independent mechanism). In this article, the mechanisms of the individual types of injury will be described. Specific groups of drugs will be linked to specific injuries. Additionally, the risk factors for the development of AKI and the methods for preventing and/or treating the condition will be discussed.https://www.mdpi.com/1422-0067/22/11/6109acute kidney injurynephrotoxicityacute tubular necrosiscasts nephropathyinterstitial nephritis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ewa Kwiatkowska Leszek Domański Violetta Dziedziejko Anna Kajdy Katarzyna Stefańska Sebastian Kwiatkowski |
spellingShingle |
Ewa Kwiatkowska Leszek Domański Violetta Dziedziejko Anna Kajdy Katarzyna Stefańska Sebastian Kwiatkowski The Mechanism of Drug Nephrotoxicity and the Methods for Preventing Kidney Damage International Journal of Molecular Sciences acute kidney injury nephrotoxicity acute tubular necrosis casts nephropathy interstitial nephritis |
author_facet |
Ewa Kwiatkowska Leszek Domański Violetta Dziedziejko Anna Kajdy Katarzyna Stefańska Sebastian Kwiatkowski |
author_sort |
Ewa Kwiatkowska |
title |
The Mechanism of Drug Nephrotoxicity and the Methods for Preventing Kidney Damage |
title_short |
The Mechanism of Drug Nephrotoxicity and the Methods for Preventing Kidney Damage |
title_full |
The Mechanism of Drug Nephrotoxicity and the Methods for Preventing Kidney Damage |
title_fullStr |
The Mechanism of Drug Nephrotoxicity and the Methods for Preventing Kidney Damage |
title_full_unstemmed |
The Mechanism of Drug Nephrotoxicity and the Methods for Preventing Kidney Damage |
title_sort |
mechanism of drug nephrotoxicity and the methods for preventing kidney damage |
publisher |
MDPI AG |
series |
International Journal of Molecular Sciences |
issn |
1661-6596 1422-0067 |
publishDate |
2021-06-01 |
description |
Acute kidney injury (AKI) is a global health challenge of vast proportions, as approx. 13.3% of people worldwide are affected annually. The pathophysiology of AKI is very complex, but its main causes are sepsis, ischemia, and nephrotoxicity. Nephrotoxicity is mainly associated with the use of drugs. Drug-induced AKI accounts for 19–26% of all hospitalized cases. Drug-induced nephrotoxicity develops according to one of the three mechanisms: (1) proximal tubular injury and acute tubular necrosis (ATN) (a dose-dependent mechanism), where the cause is related to apical contact with drugs or their metabolites, the transport of drugs and their metabolites from the apical surface, and the secretion of drugs from the basolateral surface into the tubular lumen; (2) tubular obstruction by crystals or casts containing drugs and their metabolites (a dose-dependent mechanism); (3) interstitial nephritis induced by drugs and their metabolites (a dose-independent mechanism). In this article, the mechanisms of the individual types of injury will be described. Specific groups of drugs will be linked to specific injuries. Additionally, the risk factors for the development of AKI and the methods for preventing and/or treating the condition will be discussed. |
topic |
acute kidney injury nephrotoxicity acute tubular necrosis casts nephropathy interstitial nephritis |
url |
https://www.mdpi.com/1422-0067/22/11/6109 |
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