Summary Renal therapeutics and aki

Renal Therapeutics and AKI
Nephrotoxic medicines




 Some medicines can cause kidney damage.
 By altering kidney function:
o Direct toxicity: damaging kidney cells
o Blood flow disruption
o Renal tubular damage
o Crystal formation: crystals form and obstruct the flow of urine.
o Immune-mediated reactions: inflammation
o Altered electrolyte balance: e.g., diuretics cause imbalances.
o Metabolic effects of drugs: toxic metabolites.
Patients at risk
 Over 60
 Underlying renal impairment
 Volume depletion
 Diabetes
 Sepsis
 Heart failure
Preventative measures
 Non-nephrotoxic medicines
 Correcting risk factors
 Ensure baseline renal function before starting on these.
 Monitor renal function.
 Avoid combinations of nephrotoxic medicines
Awareness
 Help you identify possible medical causes of renal failure.
 Ensure further nephrotoxic medicines are not further prescribed.
 Appropriate dosage adjustments