Drug-induced acute renal failure: recognizing and treating prerenal, postrenal, and pseudorenal injury.

Drug-induced acute renal failure: recognizing and treating prerenal, postrenal, and pseudorenal injury.

Frazee L A; Rutecki G W; Whittier F C

Consultant (00107069)

1997

1997-05

Angiotensin-converting enzyme (ACE) inhibitors and NSAIDs are among the drugs most commonly associated with acute renal failure (ARF). Patients at risk for ACE inhibitor-induced ARF include those with congestive heart failure (CHF) or compromised left ventricular (IV) function and those receiving diuretics. In these settings, discontinue the ACE inhibitor and direct therapy toward correcting volume or improving the ineffective circulation (by appropriately reducing afterload, by ensuring adequate IV filling pressures, and by treating ischemia). Risk factors for NSAID-included ARF include CHI, poor renal perfusion, and recent hospitalization. Postrenal ARF may be precipitated by drugs that are highly insoluble in addic urine, such as antineoplastic agents and HmG-CoA reductase inhibitors. Alkalinization of urine and hydration are the cornerstones of management of this type of ARF.

Female; Male; Aged; Risk Factors; Hemodynamics; Physical Examination; Inpatients; Middle Age; Kidney Function Tests; Kidney Failure; Nephrotoxicity; Antiinflammatory Agents; Acute – Etiology; Angiotensin-Converting Enzyme Inhibitors – Adverse Effects; Antineoplastic Agents – Adverse Effects; Non-Steroidal – Adverse Effects; Acute – Chemically Induced; Acute – Diagnosis; Acute – Therapy; Enzyme Inhibitors – Adverse Effects; Renal Circulation – Drug Effects

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

1265–1274

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