Drug-induced acute renal failure: keys to recognizing and treating intrarenal toxicity.
Adult; Female; Male; Aged; Risk Factors; Kidney Function Tests; Kidney Failure; Physiologic; Monitoring; Nephrotoxicity; Antiinflammatory Agents; Non-Steroidal – Adverse Effects; Acute – Chemically Induced; Acute – Diagnosis; Acute – Therapy; Aminoglycosides – Adverse Effects; Amphotericin B – Adverse Effects; Contrast Media – Adverse Effects; Drugs – Adverse Effects; Nephrotoxicity – Prevention and Control
Drug-induced acute tubular necrosis is a primary cause of acute renal failure (ARF); it may result from the use of such agents as aminoglycosides, amphotericin B, and radilocontrast media. To reduce the risk of aminoglycoside toxicity, prescribe the shortest course possible, use once-daily dosing, monitor serum concentrations, and avoid using these agents altogether in patients with known risk factors. Radiocontrast media-associated ARF is most likely to occur with preexisting renal damage, especially in a patient with diabetes mellitus. Since sodium depletion is the most important risk factor for nephrotoxic injury with amphotericin B use, saline loading is recommended both before and during drug administration. Drug-induced acute interstitial nephritis, another important cause of ARF, has been associated with a number of antibiotics, especially penicillin and ampicillin; many patients recover with the removal of the offending agent.
Frazee L A; Rutecki G W; Whittier F C
Consultant (00107069)
1997
1997-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Kidney disease: a guide to early detection and long-term care.
Kidney Function Tests; Kidney Failure; Chronic; Renal Insufficiency – Complications; Nephrotoxicity – Prevention and Control; Creatinine – Analysis; Renal Insufficiency – Diagnosis; Renal Insufficiency – Physiopathology; Renal Insufficiency – Therapy
Early detection and careful management of kidney disease can help slow or halt progression to renal failure. Early diagnosis is based on a history and physical examination, urinalysis (with dipstick testing for protein, blood, and pH), and microscopic evaluation of spun sediment. Measure serum creatinine annually in all your hypertensive patients and biennially in other adults. Determine creatinine clearance in those whose serum levels are elevated and in patients over age 60 who are taking renally excreted drugs. Strict blood pressure control is essential; also, try to avoid nephrotoxins, treat urinary tract infections, and carefully adjust dosages of any medications that require renal excretion.
Rutecki G W; Whittier F C
Consultant (00107069)
1993
1993-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).