Drug-Induced Acute Kidney Injury
Drug-induced nephrotoxicity is the third most common cause of acute kidney injury (AKI). The aim of the study was to analyse and summarise data on the factors and mechanisms responsible for increased risk of drug-induced AKI, to analyse potential methods of its prevention and treatment. At present,...
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| Format: | Article |
| Language: | Russian |
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Ministry of Health of the Russian Federation, Federal State Budgetary Institution «Scientific Centre for Expert Evaluation of Medicinal Products»
2021-10-01
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| Series: | Безопасность и риск фармакотерапии |
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| Online Access: | https://www.risksafety.ru/jour/article/view/228 |
| _version_ | 1797224616874213376 |
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| author | E. V. Zakharova O. D. Ostroumova M. V. Klepikova |
| author_facet | E. V. Zakharova O. D. Ostroumova M. V. Klepikova |
| author_sort | E. V. Zakharova |
| collection | DOAJ |
| description | Drug-induced nephrotoxicity is the third most common cause of acute kidney injury (AKI). The aim of the study was to analyse and summarise data on the factors and mechanisms responsible for increased risk of drug-induced AKI, to analyse potential methods of its prevention and treatment. At present, the following phenotypes of drug-induced AKI are distinguished: acute vascular disease, acute glomerular disease, acute tubular injury / necrosis, and acute interstitial nephritis. It was discovered that most often these complications occur following the use of antimicrobial drugs, renin-angiotensin-aldosterone system inhibitors, non-steroidal anti-inflammatory drugs, and anticancer drugs, including targeted therapy. Risk factors for drug-induced AKI include age >65, female gender, low body weight, pre-existing chronic kidney disease, hypovolemia, hypoalbuminemia, acute and chronic heart failure, diabetes, malignancies, liver cirrhosis, prolonged use of nephrotoxic drugs, and simultaneous use of two or more nephrotoxic drugs. Discontinuation of the drug which resulted in kidney failure is the first and foremost principle for managing not only drug-induced, but all AKI patients. The use of potentially nephrotoxic drugs should be avoided, especially in high-risk patients, in order to prevent drug-induced AKI. If a patient needs a drug that affects renal hemodynamics, the therapy should begin with a minimum effective dose, and combinations of two and more nephrotoxic drugs should be avoided. Close monitoring of kidney function is crucial for high-risk patients. They should also be informed about the importance of adequate water consumption schedule for prevention of hypovolemia. |
| first_indexed | 2024-03-08T22:27:30Z |
| format | Article |
| id | doaj.art-8258788ca77447eab62ea49ba429d9c5 |
| institution | Directory Open Access Journal |
| issn | 2312-7821 2619-1164 |
| language | Russian |
| last_indexed | 2024-04-24T13:55:57Z |
| publishDate | 2021-10-01 |
| publisher | Ministry of Health of the Russian Federation, Federal State Budgetary Institution «Scientific Centre for Expert Evaluation of Medicinal Products» |
| record_format | Article |
| series | Безопасность и риск фармакотерапии |
| spelling | doaj.art-8258788ca77447eab62ea49ba429d9c52024-04-03T17:56:37ZrusMinistry of Health of the Russian Federation, Federal State Budgetary Institution «Scientific Centre for Expert Evaluation of Medicinal Products»Безопасность и риск фармакотерапии2312-78212619-11642021-10-019311712710.30895/2312-7821-2021-9-3-117-127194Drug-Induced Acute Kidney InjuryE. V. Zakharova0O. D. Ostroumova1M. V. Klepikova2Russian Medical Academy of Continuous Professional Education; Botkin HospitalRussian Medical Academy of Continuous Professional Education; I. M. Sechenov First Moscow State Medical University (Sechenov University)Russian Medical Academy of Continuous Professional EducationDrug-induced nephrotoxicity is the third most common cause of acute kidney injury (AKI). The aim of the study was to analyse and summarise data on the factors and mechanisms responsible for increased risk of drug-induced AKI, to analyse potential methods of its prevention and treatment. At present, the following phenotypes of drug-induced AKI are distinguished: acute vascular disease, acute glomerular disease, acute tubular injury / necrosis, and acute interstitial nephritis. It was discovered that most often these complications occur following the use of antimicrobial drugs, renin-angiotensin-aldosterone system inhibitors, non-steroidal anti-inflammatory drugs, and anticancer drugs, including targeted therapy. Risk factors for drug-induced AKI include age >65, female gender, low body weight, pre-existing chronic kidney disease, hypovolemia, hypoalbuminemia, acute and chronic heart failure, diabetes, malignancies, liver cirrhosis, prolonged use of nephrotoxic drugs, and simultaneous use of two or more nephrotoxic drugs. Discontinuation of the drug which resulted in kidney failure is the first and foremost principle for managing not only drug-induced, but all AKI patients. The use of potentially nephrotoxic drugs should be avoided, especially in high-risk patients, in order to prevent drug-induced AKI. If a patient needs a drug that affects renal hemodynamics, the therapy should begin with a minimum effective dose, and combinations of two and more nephrotoxic drugs should be avoided. Close monitoring of kidney function is crucial for high-risk patients. They should also be informed about the importance of adequate water consumption schedule for prevention of hypovolemia.https://www.risksafety.ru/jour/article/view/228drug-induced acute kidney injurydrugsadverse drug reactionsantibioticsrenin-angiotensin-aldosterone system inhibitorsnon-steroidal anti-inflammatory drugsanticancer drugs |
| spellingShingle | E. V. Zakharova O. D. Ostroumova M. V. Klepikova Drug-Induced Acute Kidney Injury Безопасность и риск фармакотерапии drug-induced acute kidney injury drugs adverse drug reactions antibiotics renin-angiotensin-aldosterone system inhibitors non-steroidal anti-inflammatory drugs anticancer drugs |
| title | Drug-Induced Acute Kidney Injury |
| title_full | Drug-Induced Acute Kidney Injury |
| title_fullStr | Drug-Induced Acute Kidney Injury |
| title_full_unstemmed | Drug-Induced Acute Kidney Injury |
| title_short | Drug-Induced Acute Kidney Injury |
| title_sort | drug induced acute kidney injury |
| topic | drug-induced acute kidney injury drugs adverse drug reactions antibiotics renin-angiotensin-aldosterone system inhibitors non-steroidal anti-inflammatory drugs anticancer drugs |
| url | https://www.risksafety.ru/jour/article/view/228 |
| work_keys_str_mv | AT evzakharova druginducedacutekidneyinjury AT odostroumova druginducedacutekidneyinjury AT mvklepikova druginducedacutekidneyinjury |