About Careers Internship MedBlogs Contact us
Medindia LOGIN REGISTER
Advertisement

Drug-Induced Kidney Disease

Last Updated on Jan 12, 2019
Font : A-A+

What is Nephrotoxicity?

Nephrotoxicity means damage to kidney function, as a result of which kidney-specific function like excretion of waste does not happen. Nephro comes from Greek and means ‘kidney’.

Approximately 20% of damage to kidney or nephrotoxicity happens due to drugs and this is more common in patients admitted to the hospital.

Advertisement

This damage can be caused by external or internal toxicants. If not addressed or treated in time, it can lead to chronic kidney disease or acute renal failure (ARF) and severe renal disease.

Acute kidney failure also known as acute renal failure can occur suddenly since the kidneys are unable to filter the toxic products from blood. This results in high levels of toxins in blood. It can be fatal in some conditions.

What is Drug-induced Nephrotoxicity?

Some drugs used for treatment are known to cause nephrotoxicity, i.e. impair the functioning of kidney. These could be prescription or over-the -counter medications.

Drug induced nephrotoxicity occurs in patients with certain clinical conditions.

Nephrotoxic drugs generally induce inflammation in glomerulus and proximal tubules which disturbs the kidney functions and leads to toxicity known as glomerulonephritis and intestinal nephritis.

Which Drugs Cause Nephrotoxicity?

Drugs which could cause nephrotoxicity include:

Chemotherapeutic agents to treat cancer

  • Cisplatin
  • Methotrexate
  • Doxorubicin

Antibiotics

  • Beta lactums like Penicillins and Cephalosporins
  • Rifampin
  • Sulfonamides
  • Tetracyclines
  • Aminoglycosides antibiotics to treat Gram-negative infections like Gentamicin. Amikacin, Kanamycin, Tobramycin, Streptomycin and Neomycin
  • Anti-fungal antibiotics like -
    • Amphotericin B
Advertisement

Immunosuppressants to treat Rejection or Auto-immune disease

  • Azathioprine
  • Cyclosporine
  • Tacrolimus

Analgesics

  • Acetaminophen
  • Non-Steroidal-inflammatory drugs (NSAID) like – Aspirin, Celecoxib, Diclofenac, Diflunisal, Etodolac, Ibuprofen, Indomethacin, Ketoprofen, Ketorolac Nabumetone, Naproxen, Oxaprozin, Piroxicam, Salsalate, Sulindac, Tolmetin

Antidepressants and Mood stabilizers

  • Fluoxetine
  • Doxepin
  • Amitriptyline
  • Antiretrovirals
  • Tenofovir
  • Indinavir

Cardiovascular agents

  • ACE inhibitors like Benazepril, Captopril, Enalapril, Fosinopril, Lisinopril, Moexipril, Perindopril, Quinapril, Ramipril, Trandolapril
  • Clopidogrel
  • Statins like - Atorvastatin, Fluvastatin, Lovastatin, Pravastatin, Rosuvastatin, Simvastatin and Pitavastatin

Other medications

  • Cimetidine
  • Allopurinol
  • Contrast dye
  • Drugs of abuse like Cocaine
  • Streptokinase inhibitors
  • Some herbal drugs

What is mechanism of action of nephrotoxicity?

The mechanism of drug-induced nephrotoxicity varies with the class of drugs. The drugs exhibit their toxic effect by affecting various microscopic components of the kidney.

The nephrotoxic antibiotics induce their effects by two different mechanisms:

  • Penicillin and Cephalosporin type antibiotics show their effect by indirect action, which is due to antigen and antibody formation and is due to mechanism involving the immune system
  • The Polymyxin and Sulfonamide type antibiotics have a direct effect on kidneys. They show significant nephrotoxicity, the clinical diagnosis is characterized by proteinuria, decreased clearance of creatinine, and cellular casts in urine

The drug-related renal syndromes include:

References:

  1. Drug-Induced Nephrotoxicity - (https://www.aafp.org/afp/2008/0915/p743.html)
  2. Drug-induced Kidney Diseases - (http://www.japi.org/october2003/R-970.pdf)
  3. Drug-Induced Nephrotoxicity and Its Biomarkers - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3794522/)
  4. Drug-induced renal disorders - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4594214/)
  5. Pharmacology behind Common Drug Nephrotoxicities - (https://cjasn.asnjournals.org/content/early/2018/04/04/CJN.00150118)
  6. Nephrotoxicity and Renal Pathophysiology: A Contemporary Perspective - (https://www.ncbi.nlm.nih.gov/pubmed/29939355)
  7. Diagnosis, Treatment, and Prevention of Nephrotoxicity of Cancer Therapeutic Agents - (https://www.ncbi.nlm.nih.gov/books/NBK12686/)

Latest Publications and Research on Drug-Induced Kidney Disease

Citations   close

Please use one of the following formats to cite this article in your essay, paper or report:

  • APA

    Jayashree Thakwani. (2019, January 12). Drug-Induced Kidney Disease | Nephrotoxicity. Medindia. Retrieved on Jun 26, 2022 from https://www.medindia.net/patientinfo/drug-induced-kidney-disease.htm.

  • MLA

    Jayashree Thakwani. "Drug-Induced Kidney Disease | Nephrotoxicity". Medindia. Jun 26, 2022. <https://www.medindia.net/patientinfo/drug-induced-kidney-disease.htm>.

  • Chicago

    Jayashree Thakwani. "Drug-Induced Kidney Disease | Nephrotoxicity". Medindia. https://www.medindia.net/patientinfo/drug-induced-kidney-disease.htm. (accessed Jun 26, 2022).

  • Harvard

    Jayashree Thakwani. 2021. Drug-Induced Kidney Disease | Nephrotoxicity. Medindia, viewed Jun 26, 2022, https://www.medindia.net/patientinfo/drug-induced-kidney-disease.htm.


Do you wish to consult a Nephrologist for your problem? Ask your question

Dr. Deepak Selvanathan
Dr. Deepak Selvanathan
MBBS, DNB, DM, DrNB
1 year experience
Madras Medical Mission, moggapair, Chennai
Dr. Rajeevalochana Parthasarathy
Dr. Rajeevalochana Parthasarathy
10 years experience
Madras medical mission, Annanagar, Chennai
Dr. Hareesh M V K
Dr. Hareesh M V K
MBBS, MD, DM
13 years experience
Dr. (lt Col) Kuldeep Singh
Dr. (lt Col) Kuldeep  Singh
MBBS, MD, DNB
13 years experience
Apollo Spectra Hospital, Mall Road, Kanpur Nagar
View All

Post a Comment

Comments should be on the topic and should not be abusive. The editorial team reserves the right to review and moderate the comments posted on the site.

Advertisement
Recommended Reading
Advertisement
Health Topics A - Z
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z



    What's New on Medindia
    COVID Toes
    International Yoga Day 2022 - 'Yoga for Humanity'
    Wearable Devices Are Now Transforming Depression, Multiple Sclerosis, and Epilepsy Management.
    View all

    Medindia Newsletters Subscribe to our Free Newsletters!
    Terms & Conditions and Privacy Policy.

    Most Popular on Medindia

    Drug - Food Interactions Accident and Trauma Care Turmeric Powder - Health Benefits, Uses & Side Effects Calculate Ideal Weight for Infants Blood - Sugar Chart Selfie Addiction Calculator Iron Intake Calculator Post-Nasal Drip Loram (2 mg) (Lorazepam) A-Z Drug Brands in India

    Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

    © All Rights Reserved 1997 - 2022

    This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use
    open close
    CONSULT A DOCTOR