Druginduced nephrotoxicity accounts for approximately 20% of all acute kidney injuries 1. Symposium on drug effects on the kidney gentamicininduced nephrotoxicity. Finally, determination of a patients or donors genotype of drugmetabolizing genes or of mol. Study of protective effects of stem bark extracts of ficus racemosa in drug induced nephrogenic diabetes insipidus and nephrotoxicity in animal models. Pathophysiology of nephrotoxic acute renal failure h umans are exposed intentionally and unintentionally to a variety of diverse chemicals that harm the kidney. All compartments of the kidney can be affected by drug induced nephrotoxicity. Nephrotoxicity associated with ciprofloxacin is uncommon. The medical records of icu patients receiving colistin therapy in hospital serdang and hospital sungai. A number of factors have been identified as adding risk to the development of tdfinduced nephrotoxicity including advanced age, low body mass index bmi, diabetes mellitus dm, hypertension htn, couse of other nephrotoxic drugs such as protease inhibitors pi and didanosine, treatment experience, and genetic polymorphism in transporters involved in regulating tdf intracellular.
Full text druginduced impairment of renal function ijnrd. Influence of iron, deferoxamine and ascorbic acid on gentamicininduced nephrotoxicity in rats. Further, there were fewer histopathological signs of nephrotoxicity in the groups treated. Contrastinduced nephrotoxicity cin is a form of acute kidney injury that follows intravascular contrast media exposure. Gentamicininduced nephrotoxicity in adult sheep majid fartashvand, ghafour mousavi.
Druginduced nephrotoxicity tends to be more common among certain patients and in specific clinical situations. Pemetrexed induced acute kidney injury in patients with nonsmall cell lung cancer. Effect of dimethyl sulfoxide on gentamicininduced nephrotoxicity in rats. The effect of nacetylcysteine on ifosfamideinduced nephrotoxicity. However, its usefulness is limited by its nephrotoxicity. Fartashvand et al gentamicininduced nephrotoxicity in adult. This study aims to evaluate colistininduced nephrotoxicity among malaysian population. Recently, it has been shown that eryngium caucasicum can act as a free. International institute of cellular and molecular pathology.
The effect of fleroxacin on gentamicin induced nephrotoxicity was evaluated with female spraguedawley rats. In doing so, we will summarize risk factors for nephrotoxicity. Effects of pretreatment with singledose or intermittent. Other contributing factors to the nephrotoxicity of ags are the generation of free radicals and the decrease of renal blood flow through local enhancement of the vasoconstrictors, blocking the vasodilators and promoting leukocyte margination. The aim of this study is to evaluate the potential protective effects of sildenafil on gentamicininduced nephrotoxicity in rats. Chronotoxicity of streptomycininduced renal injury in mice jstage. It is well known that cisdiamminedichloroplatinum ii or cisplatin cp is a major chemotherapeutic drug for treatment of testicular, ovarian, and cervical cancers as well as many types of other solid tumors such as head and neck cancers 1, 2. Melatonin can attenuate ciprofloxacin induced nephrotoxicity. As explained, oxidative stress and inflammation are two factors contributing to gentamicininduced nephrotoxicity and regarding the antioxidant and antiinflammatory properties of crocin, the present study was designed to evaluate the protective effects of crocin against gentamicininduced renal disturbances in. Protective effect of kcl loading in gentamicin nephrotoxicity. Nephrotoxic effects of aminoglycosides on the developing. Molecular mechanisms of colistininduced nephrotoxicity. In the present study, we examined effect of oleuropein on the paraoxonase 1 pon1 activity, lipid peroxidation, lipid profile, atherogenic indexes, and relationship of pon1 activity by highdensity lipoproteincholesterol hdlc and atherogenic indices in gentamicin gminduced nephrotoxicity in rats.
As the use of aminoglycosides became more widespread, the toxic effects of these agents, most notably ototoxicity and nephrotoxicity, became more apparent. Melatonin is a wellknown direct free radical scavenger and directly neutralizes a number of free radicals and related toxicants as well as stimulates. However, nephrotoxicity, which is the main adverse effect of cp administration, limits the drug utilization in cancer treatment. At the ultrastructural level, the earliest lesions observed concern the. Aminoglycosideinduced nephrotoxicity indiana university. Pdf attenuation of gentamicininduced nephrotoxicity in. Protective effect of kcl loading in gentamicin nephrotoxicity jeffrey r.
Gentamicininduced preconditioning of proximal tubular. The precise and complete mechanism of gentamicin nephrotoxicity is still point of speculation and an unfinished story. Cronin, md aminoglycoside nephrotoxicity in experimental animals can be reduced by calcium loading, inducing diabetes, and giving thyroid hormone, while a potassium deficient diet enhances aminoglycoside nephrotoxicity. Nowadays, reemergence of this antibiotic for multidrug resistant gramnegative infections, and a new high dosing regimen recommendation increases concern about its nephrotoxicity. Van induced nephrotoxicity has been reported to occur in 525% of patients 2, 8, although this incidence can rise to 20 35%, with a consequent increase in. Amphotericin b remains the antifungal drug of choice for most systemic infections, but a limiting factor for its use is the development of nephrotoxicity. As the list of drugs, natural products, industrial chemicals and environmental pollutants that. Due to high relative blood flow the kidney is prone to drug induced damage. Gentamicin, an aminoglycoside antibiotic, is used for the treatment of serious gramnegative infections.
N2 aminoglycosides remain critical antibiotics in the armamentarium for serious gramnegative bacterial infections despite their wellknown risk for nephrotoxicity and ototoxicity. The 6rs of drug induced nephrotoxicity linda awdishu1,2 and ravindra l. Sildenafil, a selective phosphodiesterase5 inhibitor, was reported to prevent or decrease tissue injury. Nephrotoxicity of ionic and nonionic contrast media in 1196 patients. Nephrotoxins are chemicals displaying nephrotoxicity. Ciprofloxacininduced nephrotoxicity in patients with cancer. Moreover, great at tention should be paid to drug interactions. Colistin is an antibiotic that was introduced many years ago and was withdrawn because of its nephrotoxicity. Nephrotoxic definition of nephrotoxic by merriamwebster. Aminoglycosideinduced nephrotoxicity article pdf available in journal of pharmacy practice 276 september 2014 with 1,253 reads how we measure reads. Nephrotoxicity is the side effect that most limits the dose of van, particularly in patients receiving high doses or combinations with other antibiotics, such as aminoglycosides 7. Get a printable copy pdf file of the complete article 1.
Effect of superoxide dismutase treatment on gentamicin nephrotoxicity in rats. Cin may be preventable because its risk factors are well established and the timing of renal insult is commonly known in advance. Fom decreased nedaplatininduced nephrotoxicity, as shown by reduced blood urea nitrogen bun, serum creatinine levels, and urinary excretion of nacetyl. Druginduced nephrotoxicity is a renal dysfunction that occurs as a result of exposure to nephrotoxic. Aminoglycosides are concentrationdependent, bactericidal agents that undergo active transport into the cell where they inhibit protein synthesis on the 30s subunit of the bacterial ribosome.
However, all agents also carry adverse drug effect profiles. Amphotericin binduced nephrotoxicity is manifested as azotaemia, renal tubular acidosis, impaired renal concentrating ability and electrolyte abnormalities like hypokalaemia and sodium and. The 3 clinical syndromes that can be recognised in druginduced nephropathy are acute renal failure, chronic interstitial nephritis and the nephrotic syndrome. Druginduced kidney diseases np singh, a ganguli, a prakash abstract druginduced kidney disease constitutes an important cause of acute renal failure and chronic kidney disease in present day clinical practice. More side effects increased nephrotoxicity change in the drug metabolism 4. Druginduced nephrotoxicity and its biomarkers ncbi. Colistinassociated nephrotoxicity among patients in.
Pharmaceutical agents provide diagnostic and therapeutic utility that are central to patient care. In recent years gentamicin nephrotoxicity is significantly reduced by shifting to once daily dosage as well as by eliminating known risk factors. Druginduced impairment of renal function george sunny pazhayattil, anushree c shirali section of nephrology, yale university school of medicine, new haven, ct, usa abstract. Sildenafil ameliorates gentamicininduced nephrotoxicity. Nephrotoxicity and agents responsible nephrotoxic injury is damage to one or both kidenys that result from exposure to a toxic substance. Pdf effect of withania somnifera on gentamicin induced. Pdf gentamicin induced nephrotoxicity in albino mice. There are various forms, and some drugs may affect kidney function in more than one way.
Pdf how to prevent, recognize, and treat druginduced. While most of these are clinically insignificant, some drugs. Mehta2 abstract drug induced kidney injury is a frequent adverse event which contributes to morbidity and increased healthcare utilization. Pemetrexedinduced acute kidney failure following irreversible renal damage. Review boards at each participating center and all patients gave informed consent. The effect of coadministration of fosfomycin fom on nedaplatininduced nephrotoxicity in rats was investigated for 6 days. Pdf due to high relative blood flow the kidney is prone to druginduced damage. Nephrotoxins are substances displaying nephrotoxicity nephrotoxicity should not be confused with the fact that some medications are predominantly excreted by. It is a poisonous effect of some substances, both toxic chemicals and medications, on kidney function. We sought to unravel medicinal therapeutic function of w. Animals were injected during 4 or 10 days with saline nacl. Gentamicin nephrotoxicity is one of the common causes of drug induced aki in hospitalized patients. However, contrastinduced nephrotoxicity is still the third leading cause of iatrogenic renal failure.
Acute kidney injury serum creatinine increase of 0. Nephrotoxicity definition of nephrotoxicity by medical. Aminoglycoside type antibiotic gentamicin is one of the leading cause of drug induced nephrotoxicity. Low multiples of human therapeutic doses to animals e. The drug induced nephrotoxicity is more common in patients receiving certain medication and undergoing certain specific clinical conditions. Colistininduced nephrotoxicity is a concern with disparity in the reported rates between previous studies. Different mechanisms of drug induced acute kidney injury aki can be described such as prerenal aki, tubulopathies. Patients at highest risk of druginduced nephrotoxicity are those with one or more of the following. These drugs require special consideration prior to prescribing them. Different classes of drugs, by virtue of immunological mechanisms or direct toxicity initiate certain stereotyped renal responses. Several drugs and other compounds can induce acute andor chronic nephrotoxicity.
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