[Are we underestimating the nephrotoxicity of drugs?]

Abstract

In the submitted review the authors discuss the nephrotoxicity of drugs which is a serious danger of pharmacotherapy. Clinically it may be manifested in different ways from acute deterioration of renal functions to the picture of chronic renal insufficiency. It is particularly important to know the nephrotoxic potential of different drug groups and to ensure a careful stratification of patients. The most frequent drug groups which lead to affection of the kidneys are radiocontrasting substances, aminoglycoside antibiotics, non-steroid analgesics-antiphlogistics and ACE inhibitors. With the increasing number of transplantations the problem of nephrotoxicity of immunosuppressives is becoming important. The authors analyze in each group risk factors, the pathogenesis, clinical picture and prognosis of damage. Special emphasis is laid on adherence to preventive measures and careful monitoring of the laboratory and clinical picture, in particular in risk groups of patients as treatment of already developed nephrotoxic sequelae of pharmacotherapy is frequently difficult.