DRUG-ASSOCIATED RENAL INJURY



Renal dysfunction associated with the admin­istration of pharmaceutical agents is a common clinical problem. The classification of drug-re­lated renal - dysfunction is somewhat arbitrary, and several drugs are associated with more than one mechanism of injury. The classification shown in indicates a primary sepa­ration into those drugs that are associated with an acute change in kidney function and a clinical latter category may properly be considered “toxic nephropathy.” Although the toxic nephropathy variant of the acute renal failure syndrome is usu­ally taken to imply drug-associated injury to the renal tubules, the term has been extended in re­cent years to include drugs that cause immuno­logical injury to the kidney (glomerulonephritis and acute interstital nephritis) and drugs that ad­versely affect Tenal function by virtue of their ef­fects on renal blood flow regulation. The termi­nology and overlapping types of injury may be a source of confusion. Nonetheless, a number of drug-related injuries present a relatively fixed clinical picture. Examples of the more common forms of toxic nephropathies are discussed sep­arately.