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(Immun‑)Pathologie von Medikamentennebenwirkungen in der Niere

(Immuno‑)Pathology of drug side effects in the kidney

  • Schwerpunkt: Immunpathologie
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Zusammenfassung

Die Niere ist in ihrer Funktion seit jeher von Medikamentennebenwirkungen stark betroffen, wobei hier sowohl tubulointerstitielle, glomeruläre und vaskuläre Nierenveränderungen infolge direkter oder indirekter Schädigungsmechanismen vorkommen können. In jüngster Zeit hat nun v. a. die ständig wachsende Zahl an in ihrem Wirkmechanismus gänzlich neuen und unterschiedlichen Medikamenten im Bereich der Onkologie zu einer Zunahme der direkten und indirekten medikamentenassoziierten Nebenwirkungen an der Niere geführt. Diese können einerseits mit klassischen Nierensymptomen wie Proteinurie und Hämaturie, zum ganz überwiegenden Teil jedoch mit einem akuten Nierenversagen einhergehen. Aus klinischer Sicht ist es wichtig, diese Nebenwirkungen rasch zu erkennen und adäquat, z. B. durch Absetzen des auslösenden Medikaments, zu behandeln, um eine Erholung der Nierenfunktion zu erzielen und einen dauerhaften Verlust der Nierenfunktion zu vermeiden.

Einige der häufigen renalen Medikamentennebenwirkungen sollen im Folgenden näher besprochen werden.

Abstract

Nephrotoxicity or renal side effects of drugs are frequent and may vary in their clinical presentation. Various types of acute and chronic kidney disease are known to develop as a consequence or side effect of a long list of drugs with nephrotoxicity most commonly being associated with injury in the tubulointerstitial compartment. In addition, drug-induced glomerular and vascular disease have also been reported, either as the result of direct cellular injury or immune-mediated injury to glomerular or endothelial cells. From a clinical point of view it is important to recognize such drug-induced nephropathies early in order to prevent or adequately treat them to favour kidney recovery and to avoid long-lasting negative consequences for kidney function.

This article will focus on the typical morphology and pathogenesis of some frequent drug-induced renal diseases.

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Authors and Affiliations

  1. Abt. Nephropathologie, Pathologisches Institut, Universität Erlangen-Nürnberg, Krankenhausstr. 8–10, 91054, Erlangen, Deutschland

    F. Pfister,  M. Büttner-Herold &  K. Amann

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  1. F. Pfister
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  2. M. Büttner-Herold
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  3. K. Amann
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Correspondence to K. Amann.

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Interessenkonflikt

F. Pfister, M. Büttner-Herold und K. Amann geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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W. Roth, Mainz

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Pfister, F., Büttner-Herold, M. & Amann, K. (Immun‑)Pathologie von Medikamentennebenwirkungen in der Niere. Pathologe 39, 576–582 (2018). https://doi.org/10.1007/s00292-018-0475-1

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  • DOI: https://doi.org/10.1007/s00292-018-0475-1

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