Drug-Induced Alterations in Renal Hemodynamics

Chiao-Ying Hsu ； Mai-Szu Wu

《Acta Nephrologica》 26卷3期 (2012/09) Pp. 121-133

https://doi.org/10.6221/AN.2012002

並列摘要

Renal dysfunction and injury secondary to medications are common. Drug-related kidney injury can present as subtle damage or rapid progressive renal failure and is thought to be one of the major causes of renal failure. Most of the nephrotoxic medications involve directly or indirectly renal tubulointerstitial injury via immune process and lead to specific clinical findings, including microangiopathy, Fanconi syndrome, acute tubular necrosis, acute interstitial nephritis, nephrotic syndrome, obstruction, nephrogenic diabetes insipidus, electrolyte abnormalities, and chronic renal failure. Some drugs perturb renal perfusion and induce loss of filtration capacity. In vivo and in vitro research on drugrelated kidney diseases had greatly enhanced our understanding on drug nephrotoxicity in the past decade. Understanding the mechanisms involved and recognizing the clinical presentations of renal dysfunction arising from the use of commonly prescribed medications are important if injury is to be detected and prevented earlier. Knowledge of drug effects on renal hemodynamics can also give us an insight into the nature of progression of renal failure from drug-induced renal injury, which constitutes a major cause of end-stage renal disease. Drug-induced alternations in renal hemodynamics have rarely been a subject of attention. This paper reviews the clinical features and basic processes of renal hemodynamic alteration related to the use of common drugs.

並列關鍵字

drug-related nephrotoxicity ； glomerular filtration rate ； renal blood flow ； renal hemodynamics

參考文獻

Wang X, Takeya K, Aaronson PI, Loutzenhiser K, Loutzenhiser R. Effects of amiloride, benzamil, and alterations in extracellular Na+ on the rat afferent arteriole and its myogenic response. Am J Physiol Renal Physiol 295: F272-F282, 2008.

Soni SS, Gowrishankar S, Kishan AG, Raman A. Non diabetic renal disease in type 2 diabetes mellitus. Nephrology (Carlton) 11: 533-537, 2006.

Nangaku M. Mechanisms of tubulointerstitial injury in the kidney: final common pathways to end-stage renal failure. Intern Med 43: 9-17, 2004.

Baker RJ, Pusey CD. The changing profile of acute tubulointerstitial nephritis. Nephrol Dial Transplant 19: 8-11, 2004.

Ten RM, Torres VE, Milliner DS, Schwab TR, Holley KE, Gleich GJ. Acute interstitial nephritis: immunologic and clinical aspects. Mayo Clin Proc 63: 921-930, 1988.