[Secondary nephropathies in occupational health practice. II. Kidney disorders induced by drug and contrast media]

Abstract

Nowadays, drug induced kidney disorders have become a frequent health problem. Iatrogenic nephropathies are manifested by a wide variety of clinical symptoms, including acute renal failure (about 20%), one of the major negative prognostic factors in internal diseases. Occupational kidney disorders induced by exposure to chemical toxins at a work place may coincide with those caused by drugs. This comorbidity can increase the risk of their progression to further deterioration of renal function, leading finally to long lasting work disability among employees. In this paper, we analyzed the mechanism by which major nephrotoxic drugs (e.g., antibiotics, non-steroidal anti-inflammatory agents, contrast media and angiotensin converting enzyme inhibitors) exert their effect on kidneys. Special attention was paid to over-the-counter medications, which are available in many countries, and thus are frequently abused by the working population. The early identification of non-occupational causes of kidney disorders helps avoiding accumulation of nephropathies of different origin, being of great practical value.