Nephrotoxicity symptoms

Nephrotoxicity (as evidenced by increased BUN and serum creatinine levels and decreased creatinine clearance) may be reversible if the drug is stopped at the first sign of nephrotoxic symptoms. 

The aminoglycosides are potentially neurotoxic, nephrotoxic, and ototoxic and are capable of causing permanent damage to tiiese organs and structures. The nurse notifies the primary health care provider immediately when one or more signs and symptoms of tiiese adverse reactions is suspected. 

Cyclosporine is a cyclic polypeptide immunosuppressant typically used to prevent organ rejection in transplant patients. Its use is restricted to patients with fulminant or refractory symptoms in patients with active IBD. Significant toxicides associated with cyclosporine are nephrotoxicity, risk of infection, seizures, hypertension, and liver function test abnormalities.1,13,14... 

Streptomycin Adults See footnote8 Children 20-40 mg/kg per day Ototoxicity, neurotoxicity, nephrotoxicity Baseline audiogram, vestibular testing, Romber testing and SCr Monthly assessments of renal function and auditory or vestibular symptoms... 

Nephrotoxicity IDV potentially TDF Onset IDV—months after therapy TDF—weeks to months after therapy Symptoms IDV—asymptomatic rarely develop end-stage renal disease TDF—asymptomatic to symptoms of nephrogenic diabetes insipidus, Fanconi syndrome 1. History of renal disease 2. Concomitant use of nephrotoxic drugs Avoid use of other nephrotoxic drugs adequate hydration if on IDV monitor creatinine, urinalysis, serum potassium and phosphorus in patients at risk D/C offending agent, generally reversible supportive care electrolyte replacement as indicated... 

The answer is c. (Hardman, p 15.33.) Enthusiastic over medication with vitamin D may lead to a toxic syndrome called hy/jervitamijmsis D. The initial symptoms can include weakness, nausea, weight loss, anemia, and mild acidosis. As the excessive doses are continued, signs of nephrotoxicity are manifested, such as polyuria, polydipsia, azotemia, and eventually nephrocalcinosis. In adults, osteoporosis can occur. Also, there is CNS impairment, which can result in mental retardation and convulsions. 

Renai function impairment Dosage reduction is recommended with renal impairment (see Administration and Dosage). Acute renal failure and CNS symptoms have been reported in patients with underlying renal disease who have received inappropriately high doses for their level of renal function. Exercise similar caution when administering valacyclovir to elderly patients and patients receiving potentially nephrotoxic agents. 

Notify the physician if a rash, tinnitus, or signs and symptoms of nephrotoxicity occur... 

In male Fischer 344 rats treated intraperitoneally with 0, 10, 20, 40, 60 or 80 mg/kg bw acrylonitrile, significant increases in urinary volume and glucose were observed 24 h after treatment with 20 mg/kg bw (Rouisse et al., 1986). Increased levels of urinary N-acetyl-P-D-glucosaminidase were detected after treatment with 60 mg/kg bw acrylonitrile. Symptoms of nephrotoxicity were also observ ed after a 4-h exposure to 200 ppm [434 mg/m3] acrylonitrile. Histopathological examination revealed lesions in the proximal tubular region of the kidney. 

Even low-dose intravenous cyclophosphamide can cause a syndrome that resembles inappropriate secretion of antidiuretic hormone, with severe hyponatremia and symptoms of water intoxication (SEDA-19, 347 SEDA-21, 386). A direct effect on the renal tubules is likely, but no other nephrotoxic effects have been documented. 

Adverse Effects. Cidofovir may cause nephrotoxicity, especially at higher doses. This drug may also decrease the number of neutrophilic leukocytes, resulting in neutropenia and related symptoms such as fever, chills, and sore throat. Other side effects include headache and gastrointestinal disturbances (anorexia, nausea, diarrhea). 

Mechanism uncertain. Metformin does not undergo hepatic metabolism. Renal tubular secretion is the major route of metformin elimination. Aminoglycosides are also principally excreted via the kidney, and nephrotoxicity is an important side-effect Watch and monitor for hypoglycaemia, and warn patients about it - For signs and symptoms of hypoglycaemia, see Clinical Features of Some Adverse Drug Interactions, Hypoglycaemia... 

While the pattern of alclofenac toxicity resembles that of other NSAIDs, the frequency of adverse effects differs widely. Allergic reactions have been reported more frequently and skin rashes have been particularly common. Hypersensitivity reactions, including anaphylactic shock, severe generalized vasculitis, hepatotoxicity, and nephrotoxicity, have been observed. Alclofenac has therefore been withdrawn in several countries (1). Blood dyscrasias and neurological symptoms are rare. 

Bucloxic acid is an NSAID that is not widely used. The usual symptoms of gastrotoxicity, nephrotoxicity, and increased blood pressure have been reported, but the major adverse effects involve skin and allergic reactions. Quincke s edema has been observed (SED-9, 152) (1) (SEDA-1, 93). 

In summary, other symptoms of IFNa toxicity are far more common than nephrotoxicity (fevers, chills, malaise, arthralgias, fatigue anorexia, weight loss, depression, impaired cognihve function, diminished libido, abnormal thyroid function). Nevertheless, IFNa has a complicated and important relationship to the kidney but there are many confounding factors... 

Acetylsalicylic acid 650 mg q.4 hr Hepatic (renal) q.4 hr q. 4-6 hr Avoid Nephrotoxic in high doses may decrease GFR when renal blood flow is prostaglandin dependent may add to uremic Gl and hematologic symptoms protein binding reduced in ESRD Dose after dialysis None Dose for GFR 10-50 ml/min... 

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