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Drug-Induced Acute Kidney Injury

  • Randy L. Luciano
  • Mark A. Perazella
Chapter

Abstract

Drug-induced acute kidney injury (AKI) is a relatively common problem. Prescribed medications, over-the-counter drugs/substances, and diagnostic agents may alter kidney function. As the kidney filters, secretes, reabsorbs, biotransforms, and excretes many drugs, it is not surprising that acute kidney injury is an adverse effect. Drugs and their metabolites can lead to injury within all compartments of the kidney including the vasculature, glomerulus, tubules, and interstitium. Common forms of drug-induced AKI affecting the various renal compartments include thrombotic microangiopathy, membranous and minimal change/focal segmental glomerulosclerosis, acute tubular injury/necrosis, osmotic nephropathy, crystalline-induced AKI, and acute interstitial nephritis. Recognizing AKI syndromes that are associated with various agents can lead to early identification of potentially harmful drugs and therapeutic agents, reducing exposure in at-risk patients. Once identified, the medication or agent can be withheld or dose-reduced, thereby significantly impacting and potentially reducing the duration and severity of kidney injury.

Keywords

Acute kidney injury Chronic kidney disease Prerenal Intrinsic renal Postrenal Acute tubular necrosis Acute interstitial nephritis Crystalline nephropathy 

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Section of Nephrology, Department of Internal MedicineYale University School of MedicineNew HavenUSA
  2. 2.Section of NephrologyYale University School of MedicineNew HavenUSA
  3. 3.Department of MedicineYale UniversityNew HavenUSA

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