Drug-Induced Kidney Disease (DIKD)

Introduction

Drug-induced kidney disease (DIKD) can be either

• Acute and reversible when the medication is stopped, or
• Irreversible and progress to chronic kidney disease.

DIKD is best prevented by avoiding the use of potentially nephrotoxic agents for patients at increased risk for toxicity. Exposure to these drugs often cannot be avoided, so several interventions have been proposed to reduce the potential for the development of nephrotoxicity.

• Adjustment of medication dosage regimens based on accurate estimates of kidney function
• Careful and adequate hydration to establish high urine flow rates.

Nephrotoxic Medications

Common examples include

• Aminoglycosides
• Amphotericin B
• Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers
• Cisplatin
• Cyclosporine
• Loop Diuretics
• Nonsteroidal Anti-inflammatory Drugs and Selective Cyclooxygenase-2 Inhibitors
• Polymyxins
• Proton Pump Inhibitors
• Radiographic Contrast Media
• Tacrolimus
• Vancomycin

NOTE: May refer Pharmacotherapy A Pathophysiologic Approach for detailed explanations.

External Links

• Pharmacotherapy: A Pathophysiologic Approach, 2020
  
• Drug-Induced Acute Kidney Injury, 2022
  
• The 6R’s of drug induced nephrotoxicity, 2017