Nephrotoxicity can be diagnosed with simple blood tests. However, these assessments help when the damage to kidney is extensive. These tests could include:
- Serum creatinine levels in blood
- Measurement of BUN (Blood urea nitrogen)
- Creatinine clearance
- Glomerular filtration rate
The use of biomarker helps in assessing nephrotoxicity at an early stage. Some of the biomarkers include:
- Type IV Collagen - an important biomarker of nephrotoxicity- helps to indicate changes in glomerulus
- Albumin- a high molecular weight protein used to indicate kidney damage for early diagnosis of changed glomerular filtration and diabetes
- Transferrin - helps in transporting iron, is a strong indicator of glomerular damage
- Cytokines - these biomarkers are involved in glomerular and tubular damage and repair
- NGAL (Neutrophil gelatinase-associated lipocalin) - a sensitive biomarker for diagnosis of kidney injury
How do you Treat Nephrotoxicity?
Nephrotoxicity can be treated by methods listed below:
- The renal failure can be managed by maintaining the fluid volume in body, start dialysis or adjust drug doses
- The drug causing nephrotoxicity must be discontinued or its dose be altered
- In some conditions, steroid therapy may help
- Maintaining electrolyte balance
What are the Common Risk Factors for Drug-induced Nephrotoxicity?
The common risk factors include:
- Age above 60 years
- Patient already suffering from Renal insufficiency
- Sepsis
- Heart failure
- Diabetes
- Patients with dehydration and extracellular volume depletion
- Increased uric acid level or Hyperuricemia
- Prior exposure to radio contrast agents for doing X-rays or CT scan.
How do you Prevent Nephrotoxicity?
- Limit intake of NSAID drugs and limit painkillers
- Look out for words in prescription leaflet which indicate “could cause nephrotoxicity” and avoid using these drugs
- Use alternate drugs which are non-nephrotoxic drugs
- Monitor renal function during therapy and adjust dosage of drug depending on the vital signs
- Be aware of patient risk factors and avoid drugs which could cause nephrotoxicity
