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 who already suffer from renal impairment. Some drugs may affect renal function in more than one way.
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Drug-induced glomerular disease is not common but there are a few drugs that have been implicated. Glomerular lesions primarily occur through immune mediated pathways rather than through direct drug toxicity.
Nephrotoxicity is usually monitored through a simple blood test. A decreased creatinine clearance indicates poor renal function. Normal creatinine clearance levels are between 80 - 120 μmol/L. In interventional radiology, a patients' creatinine clearance levels are all checked prior to a procedure. Should an elevated creatinine clearance level be found, a special contrast medium or radiocontrast is used which is less harmful for the patient.
Serum creatinine is another measure of renal function, which may be more useful clinically when dealing with patients with early kidney disease.