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Nephrotoxicity pp 377-382 | Cite as

Assessment of Nephrotoxicity by Analysis of a Randomized Multi-Centre Comparative Study Regarding the Previous Extend of Kidney Damage

  • A. Werner Mondorf
  • Wolfgang Mondorf
  • Anita Klingen

Abstract

For the assessment of nephrotoxicity we need to differentiate between kidney alteration, kidney lesion and kidney necrosis. Any toxic agent may first alter kidney structures by means of reversible effects on kidney cells without cellular destruction and no functional impairment. More toxic agents may then lead to lesions of kidney structures by means of cellular destruction with compensate functional for the impairment of the kidney. Toxic agents leading subsequently to kidney necrosis show cellular destruction and not compensated functional impairment of the kidney damage (Table 1). The main parameters of nephrotoxicity in clinical use, such as creatinine in serum, creatinine-clearance and protein in urine are functional parameters shown to be sensitive for kidney necrosis, poorly sensitive for kidney lesions and not sensitive for kidney alteration. Concerning kidney damage they have therefore to be evaluated as late phase parameters. Every drug related nephrotoxicity begins with alteration of the kidney before leading subsequently to lesions and necrosis. It is of importance to detect nephrotoxicity in their early stages of alteration before cell destruction and consequently functional impairment occurs.

Keywords

Glycerol Creatinine Cefotaxime Aminoglycosides Ceftazidime 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    U. Burchardt, G. Schinkothe, K. Meinel, D. Anton, I. Krebbel and L. Neef, Aminoglykosidnephropathie, Z. Gesamte Inn. Med. 37:388–392 (1982).PubMedGoogle Scholar
  2. 2.
    A.W. Mondorf, J. Breier, J. Hendus, J.E. Scherberich, G. Mackenrodt, P.M. Shah, W. Stille and W. Schoeppe, Effect of aminoglycosides on proximal tubular membranes of the human kidney, Europ. J. Clin. Pharmacol. 13:133–142 (1978).CrossRefGoogle Scholar
  3. 3.
    A.W. Mondorf, W. Schoeppe, Is the potential nephrotoxicity of drugs predictible? Experiences with a volunteer model. Contr. Nephrol. 42:93–99 (1984).Google Scholar
  4. 4.
    G. Heinert, J. Wyrobnik and J. Scherberich, Quantitative computer histophotometry of membrane-integrated and lysosomal enzymes indicating inductive and alternative affects of aminoglycosides. Current Chemotherapy & Imnunotherapy, Proc.12th Internatll. Congr. of Chemotherapy, Florence, Italy, 852–854 (1981).Google Scholar
  5. 5.
    F.W. Falkenberg, U. Mondorf, D. Pierard, C. Gauhl, A.W. Mondorf, U. Mai, G. Kantwerk, U. Meier, A. Rindhage, M. Rohracker, Identification of fragments of proximal and distal tubular cells in the urine of patients under cytostatic treatment by immunoelectron microscopy with monoclonal antibodies, Am. J. Kid. Dis. 9:129–137 (1987).PubMedGoogle Scholar
  6. 6.
    R.G. Price, Urinary enzymes, nephrotoxicity and renal disease, Toxicol., 23:99–134 (1982).CrossRefGoogle Scholar
  7. 7.
    M. Nakamura, T. Itoh, K. Miyata, T. Uchisaka, T. Tanabe, M. Aono and K. Kimura, Protection by glycerol of urinary L-alanine aminopeptidase activity from freezing and thawing inactivation, Toxicol. Lett., 21:321–324 (1984).PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1989

Authors and Affiliations

  • A. Werner Mondorf
    • 1
  • Wolfgang Mondorf
    • 1
  • Anita Klingen
    • 1
  1. 1.Zentrum der Inneren MedizinUniversitatskliniken FrankfurtFrankfurt 70Germany

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