[Iatrogenic kidney diseases]

Abstract

Iatrogenic kidney diseases may appeared as the consequence of medical mistakes or as the result of drug side effects. Present paper is dedicated mainly to this second group of disorders. Spectrum of different syndromes caused by the undesirable drug effects is very long and varied. There are among them water and electrolyte, disorders, tubulo-interstitial nephritis, glomerulopathies or acute renal failure. Also list of potentially nephrotoxic drugs is very long and including many different medicines. Additionally it is important to take into account existence of many risk factors enabling appearance of drug nephrotoxicity. Most important seen to be advanced age and deterioration of renal function. Main prophylactic method preventing development of drug induced nephropaties is strict drug dosage, their adjustment according glomerular filtration rate and monitoring of water- electrolyte balance. Common automatic estimation of eGFR by diagnostic laboratories have to be useful tool in this matter. It is also important to avoid combinations of potentially nephrotoxic drugs. In case of the appearance of first symptoms of toxic renal injury specific activities dependent from the character and severity of pathological changes are necessary. Nevertheless most important issue is consciousness of this danger in both sides: physician and patients enabling avoid drug nephrotoxicity.