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toxic to the kidney

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/06 22:31:11」(JST)

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Nephrotoxicity (from Greek: nephros, "kidney") is a poisonous effect of some substances, both toxic chemicals and medication, on the kidneys. There are various forms of toxicity.^[1] Nephrotoxicity should not be confused with the fact that some medications have a predominantly renal excretion and need their dose adjusted for the decreased renal function (e.g., heparin).

Nephrotoxins are chemicals displaying nephrotoxicity.

The nephrotoxic effect of most drugs is more profound in patients already suffering from renal impairment. Some drugs may affect renal function in more than one way.

Types of toxicity

Cardiovascular

General: diuretics, β-blockers, vasodilator agents
Local: ACE inhibitors, cyclosporine,^[2] tacrolimus.^[2]

Direct tubular effect

Proximal convoluted tubule: Aminoglycoside antibiotics (e.g., gentamicin), amphotericin B, cisplatin, radiocontrast media, immunoglobulins, mannitol
Distal tubule: NSAIDs (e.g. aspirin, ibuprofen, diclofenac), ACE inhibitors, cyclosporin, lithium salts, cyclophosphamide, amphotericin B
Tubular obstruction: sulphonamides, methotrexate, aciclovir, diethylene glycol, triamterene.

Acute interstitial nephritis

β-lactam antibiotics, vancomycin, rifampicin, sulphonamides, ciprofloxacin, NSAIDs, ranitidine, cimetidine, furosemide, thiazides, phenytoin.

Chronic interstitial nephritis

Lithium (Li)
cyclosporine ^[3]

Acute glomerulonephritis

Drug-induced glomerular disease is not common but there are a few drugs that have been implicated. Glomerular lesions occur primarily through immune-mediated pathways rather than through direct drug toxicity.

Heroin and Pamidronate are known to cause focal segmental glomerulosclerosis
Gold salts therapy can cause membranous nephropathy^[3]
Penicillamine

Causes of diabetes insipidus

Lithium salts
Amphotericin B—reversible at low doses, irreversible at high doses
Fluoride
Demeclocycline
Foscarnet.

Other nephrotoxins

Heavy metals interfere with enzymes of energy metabolism.
Aristolochic acid, found in some plants and in some herbal supplements derived from those plants, has been shown to have nephrotoxic effects on humans.
Rhubarb contains some nephrotoxins which can cause inflammation of the kidneys in some people.

Surveillance

Nephrotoxicity is usually monitored through a simple blood test. A decreased creatinine clearance indicates poor renal function. Normal creatinine level is between 80 - 120 μmol/L. In interventional radiology, a patient's creatinine clearance levels are all checked prior to a procedure. Should a reduced creatinine clearance level be found, a special contrast medium or radiocontrast that is less harmful for the patient is used.

Serum creatinine is another measure of renal function, which may be more useful clinically when dealing with patients with early kidney disease.

References

^ Galley HF (2000). "Can acute renal failure be prevented". J R Coll Surg Edinb 45 (1): 44–50. PMID 10815380.
^ ^a ^b Naesens M, Kuypers DR, Sarwal M (2009). "Calcineurin inhibitor nephrotoxicity". Clin. J. Am. Soc. Nephrol. 4 (2): 481–509. doi:10.2215/CJN.04800908. PMID 19218475.
^ ^a ^b USMLE WORLD QBanks 2009, Step1, Pharmacology, Q74

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1. アミノグリコシドによる腎毒性の症状および危険因子 manifestations of and risk factors for aminoglycoside nephrotoxicity
2. 化学療法関連腎毒性および腎不全患者における用量調整 chemotherapy related nephrotoxicity and dose modification in patients with renal insufficiency
3. シクロスポリンおよびタクロリムスの腎毒性 cyclosporine and tacrolimus nephrotoxicity
4. 成人におけるバンコマイシン投与および血清濃度のモニタリング vancomycin dosing and serum concentration monitoring in adults
5. アミノグリコシドの腎毒性および聴覚毒性の病因および予防 pathogenesis and prevention of aminoglycoside nephrotoxicity and ototoxicity

English Journal

Non-protein amino acids in Australian acacia seed: implications for food security and recommended processing methods to reduce djenkolic acid.

Boughton BA1, Reddy P1, Boland MP2, Roessner U3, Yates P4.
Food chemistry.Food Chem.2015 Jul 15;179:109-15. doi: 10.1016/j.foodchem.2015.01.072. Epub 2015 Jan 20.
Seed of Australian acacia species, Acacia colei, Acacia elecantha, Acacia torulosa, Acacia turmida and Acacia saligna, were analysed for the presence of toxic non-protein amino acids and the levels of essential amino acids. Amines were derivatised with 6-aminoquinolyl-N-hydroxysuccinimidyl carbamate
PMID 25722145

Nephrotoxic contaminants in drinking water and urine, and chronic kidney disease in rural Sri Lanka.

Rango T1, Jeuland M2, Manthrithilake H3, McCornick P3.
The Science of the total environment.Sci Total Environ.2015 Jun 15;518-519:574-85. doi: 10.1016/j.scitotenv.2015.02.097. Epub 2015 Mar 14.
Chronic kidney disease of unknown ("u") cause (CKDu) is a growing public health concern in Sri Lanka. Prior research has hypothesized a link with drinking water quality, but rigorous studies are lacking. This study assesses the relationship between nephrotoxic elements (namely arsenic (As), cadmium
PMID 25782025

Acute kidney injury in adults with hemophagocytic lymphohistiocytosis.

Aulagnon F1, Lapidus N2, Canet E1, Galicier L3, Boutboul D3, Peraldi MN4, Reuter D1, Bernard R1, Schlemmer B1, Azoulay E1, Zafrani L5.
American journal of kidney diseases : the official journal of the National Kidney Foundation.Am J Kidney Dis.2015 Jun;65(6):851-9. doi: 10.1053/j.ajkd.2014.10.012. Epub 2014 Nov 4.
BACKGROUND: Acute kidney injury (AKI) in the setting of hemophagocytic lymphohistiocytosis (HLH) is poorly characterized. This study aims to describe the incidence, clinical and biological features, and outcome associated with AKI in this population.STUDY DESIGN: Case series.SETTING & PARTICIPAN
PMID 25480521

Japanese Journal

A Comparison of Nephrotoxicity of Contrast Medium in Elderly Patients who Underwent Renal or Peripheral Arterial Vascular Intervention

Internal Medicine 55(1), 9-14, 2016
NAID 130005116791

The enhancement effect of HIST1H4C knockdown on cadmium toxicity in human proximal tubular cells

Fundamental Toxicological Sciences 2(6), 259-262, 2015
NAID 130005118256

〈Cases Reports〉Successful treatment with intravenous colistin of sepsis caused by metallo-beta-lactamase-producing multidrug-resistant Pseudomonas aeruginosa in a patient with acute myeloid leukemia