Renal failure, acute drug-induced

Markowitz GS, Perazella MA Drug-induced renal failure a focus on tubulointerstitial disease. Clin Chim Acta 2005 351 31-47. Spanou Z, Keller M, Britschgi M, Yawalkar N, Fehr , Neuweiler , Gugger M, Mohaupt M, Pichler W Involvement of drug-specific cells in acute drug-induced interstitial nephritis. Am Soc Nephrol 2006 17 2919-27. 

During periods of acute psychosis, some patients exhibit so much muscular activity that they develop muscular destruction with the muscle product myoglobin in urine, which produces acute renal failure (16). Some muscle destruction may be due to involuntary muscle activity induced by the drug, while some may be due to the struggles of the agitated patient. In the latter case, the use of restraints may worsen the situation. 

Shin J, Lee E, Kwon Y, Lee J, Cho S, Park C, Lee D, Kim M-S, Pyo H-J (1997) Exercise-induced acute renal failure associated with nonsteroidal anti-inflammatory drugs report of 2 cases (in Korean with English abstract). Korean J Nephrol 16 607-611... 

Krummel T, Dimitrov Y, Moulm B, Haimedouche T. Drug points Acute renal failure induced by topical ketoprofen. BMJ 2000 320(7227) 93. 

Traditionally, when searching for the etiology of AKI, the clinician s will subdivides the potential causes of a sudden decline of GFR into one of three general pathophysiologic processes pre renal failure, intrarenal failure or post renal failure [1]. Recently, Miet et al [ 52] in discussing drug-induce acute kidney injury detailed two additional mechanisms that need to be considered in addition to those outlined in Table 2. 

Fleury D,Vanhille P, Pallet IL, Kleinknecht D. Drug induced acute renal failure a preventable disease linked to drug misuse. Kidney Inti 990 38 1238. 

Drug-induced tubulointerstitial nephritides represent 1-10% of cases of acute renal failure and is characterized by infiltrates of mononuclear cells associated with tubular cell injury. A lot of drugs are incriminated, including antibiotics (P-lactams, sulfonamides, aminoglycosides, quinolones), antiepileptic drugs, diuretics, proton pump inhibitors, foscarnet and non-steroidal anti-inflammatory drugs [73]. Most often, withdrawal of the drug, with or without concomitant administration of steroids improves the renal functions. 

Flolly MK, Dear JW, Flu X, Schechter AN, Gladwin MT, Flewitt SM, Yuen PS, Star RA Biomarker and drug-target discovery using proteomics in a new rat model of sepsis-induced acute renal failure. Kidney International 70 496-506, 2006... 

Gallelli L, Gallelli A, Vero G, Roccia F, Pelaia G, De Sarro G, et al. Acute renal failure probably induced by prulifloxacin in an elderly woman a first case report. Clinical drug investigation. 2006 26(1 ) 49-53. 

Coca S, Perazella MA. Acute renal failure associated with tenofovir evidence of drug-induced nephrotoxicity. Am J Med Sci 2002 324 342-344. 

An additional important finding from this study was the hme of onset of acute renal decompensation. Ibuprofen-induced renal failure occurred rapidly (within 8 days), but piroxicam and sulindac were not associated with any deterioration of renal function during the 11-day treatment period [39]. A pharmacokinetic analysis of the drugs used in these patients suggested the following Ibuprofen, which has a short elimination half-life, reached maximum serum concen-... 

The observation by Schwarz et al. [90] are germane to the influence of NSAID-induced AKI on the development of chronic renal failure. While NSAIDs accounted for only 20% of the cases of acute interstitial nephritis [90], nearly 2 out of every 3 patients from the NSAID subgroup was found to have permanent renal impairment at follow-up which represented the greatest frequency of any of the drug-induced acute interstitial nephritis. 

Peskoe ST, McMillan JH, Eorch A, Sussman H, Ozawa T. Reversible acute renal failure associated with chlorthalidone therapy possible drug induced interstitial nephritis. J Med Assoc Ga 1978 67 17-18. 

The mechanism of BCNU-induced nephrotoxicity is most hkely based on a direct nephrotoxic effect but differs from that of streptozotocin manifested by proximal tubular dysfunction and acute renal failure that may abate when the drug is discontinued. 

---