Kidney drugs list
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Comprehensive Overview of Kidney-Related Drugs and Their Implications
Kidney Toxicity from Herbs and Dietary Supplements
Herbs and dietary supplements (DS) have been linked to various forms of kidney toxicity. A review of case reports from PubMed identified several herbs and DS that have been associated with kidney injuries such as nephritis, nephrotic syndrome, acute kidney injury (AKI), and chronic kidney disease (CKD). Notable herbs include Chinese yew, impila, morning cypress, St. John's wort, thundergod vine, tribulus, and wormwood. Dietary supplements implicated include bile (sheep), chlorella, chromium, CKLS, creatine, glucosamine, hydrazine, N.O.-Xplode, Spanish fly, and excessive intakes of vitamins A, C, and D.
Renally Relevant Drugs for Chronic Kidney Disease
Chronic kidney disease (CKD) requires careful medication management to prevent further renal damage. A renally relevant drug list (RRD-list) was developed to aid healthcare professionals in optimizing medication for CKD patients. This list includes drugs frequently associated with renal issues and provides alternatives and advice for safer use. The RRD-list is a valuable tool for general practitioners and pharmacists to ensure safe drug treatment in CKD patients.
Epidemiology and Mechanisms of Drug-Induced Kidney Disorders
Drug-induced nephrotoxicity is a significant cause of acute kidney injury (AKI) in hospitals, accounting for 18-27% of cases. Common nephrotoxic drugs include NSAIDs, aminoglycosides, amphotericin B, and calcineurin inhibitors. These drugs can affect various parts of the kidney, leading to different types of renal dysfunction. Understanding patient risk factors and the nephrotoxic potential of these drugs is crucial for preventing kidney damage.
Therapeutic Drugs and Renal Toxicity
Therapeutic drugs can cause various forms of kidney damage, including tubulointerstitial nephritis and acute tubular necrosis, often due to antibiotics and NSAIDs. Less common are drug-induced glomerular and vascular diseases. Recognizing the histopathological changes and correlating them clinically is essential for identifying drug-induced kidney diseases.
Future Directions in Kidney Disease Drug Development
Despite the high mortality rates associated with AKI and the increasing prevalence of CKD, there are limited therapeutic options beyond renal replacement therapies. Future drug development focuses on targeting inflammation, cell death, and fibrosis. Nanomedicines and repurposed drugs, such as the chemokine receptor inhibitor CCX140 for CKD and the p53 inhibitor QPI-1002 for AKI, show promise in clinical trials.
Factors Enhancing Renal Vulnerability to Drug Toxicity
Several factors increase the kidney's vulnerability to drug toxicity, including patient-specific factors, kidney-related factors, and drug-related factors. These factors can lead to various renal syndromes such as AKI, tubulopathies, proteinuric renal disease, and CKD. Identifying and managing these risk factors is key to reducing drug-induced renal complications.
Role of Renal Drug Transporters in Drug Interactions
Renal drug transporters, primarily located in the renal proximal tubules, play a significant role in drug elimination and can influence drug efficacy, toxicity, and drug-drug interactions (DDIs). These transporters handle organic cation and anion drugs and are often targets for clinically significant DDIs. Understanding the functional characteristics of these transporters is crucial for predicting and managing DDIs .
Drug-Induced Acute Kidney Injury
Medications are a common cause of AKI, particularly in hospitalized patients. AKI can result from direct tubular injury, immune-mediated inflammation, or drug precipitation within the tubules. Clinicians must be aware of these mechanisms to prevent and treat drug-induced AKI effectively.
Mechanisms of Renal Drug Interactions
Renal drug interactions can occur through various mechanisms, including competition at tubular secretion or reabsorption sites, changes in urinary pH or flow, and inhibition of renal drug metabolism. These interactions can lead to significant changes in drug excretion and plasma concentrations, particularly when renal clearance is a major contributor to total drug clearance.
Conclusion
Understanding the complex interactions between drugs and kidney function is essential for preventing and managing drug-induced kidney diseases. Healthcare professionals must be vigilant in recognizing nephrotoxic drugs, optimizing medication for CKD patients, and understanding the mechanisms of renal drug interactions to ensure safe and effective treatment.
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