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Drug-induced Nephropathy

Toxic Nephropathy


Presentation

  • Pseudo-renal failure clinical presentation • increase in SCr OR BUN (not both) • no decrease in actual kidney function hemodynamically mediated renal failure clinical presentation • increase in SCr • decrease in GFR • happens w/in days of drug initiation[quizlet.com]
  • Bhatt’s presentation, Dr. Michelle L.[mdedge.com]
  • Presents a multi-disciplinary and international approach to critical renal care for a thorough and integrated presentation of how to care for critically ill patients with renal disease or complications.[books.google.de]
  • Its pathophysiological mechanism remains speculative and is possibly modulated according to the risk factor(s) and clinical presentation of the patients.[eurekaselect.com]
Respiratory Distress
  • A double-blind placebo-controlled study to evaluate the safety and efficacy of L-2-oxothiazolidine-4-carbosylic acid in the treatment of patients with acute respiratory distress syndrome. Crit Care Med. 2008; 36: [epub ahead of print].[annals.org]

Treatment

  • Changes in renal function associated with tenofovir disoproxil fumarate treatment, compared with nucleoside reverse-transcriptase inhibitor treatment. Clin Infect Dis. 2005;40(8):1194–8. PubMed CrossRef 42. Coca S, Perazella MA.[springermedizin.de]
  • The results of direct and indirect treatment comparisons in meta-analysis of randomized controlled trials. J Clin Epidemiol 1997;50:683-691. 4.Song F, Altman DG, Glenny AM, Deeks JJ.[annals.org]
  • The treatment arm received a 20 ng/kg/min PGE 1 intravenous infusion for 6 hours before and after the administration of contrast media. Controls received only 0.9% sodium chloride solution for routine hydration.[clinicaladvisor.com]
  • Places a special emphasis on therapeutic interventions and treatment procedures for a hands on clinical reference tool. Features a new US editor, Dr.[books.google.de]
  • Keywords: Iodinated contrast media, gadolinium chelates, apoptosis, contrast-induced nephropathy Title: Role of Apoptosis in the Pathogenesis of Contrast Media-induced Nephropathy and Hints for its Possible Prevention by Drug Treatment VOLUME: 5 ISSUE[eurekaselect.com]

Prognosis

  • Prognosis of Acute Renal Failure In-Hospital Evolution Of the patients who presented ARF, 22.2% (n 8) required renal replacement therapy at admission. Continuous veno-venous hemofiltration was employed in all these patients.[revespcardiol.org]
  • ., hypovolemia) Pathogenesis contrast media results in acute tubular necrosis via unknown mechanisms Prognosis in the majority of cases over the course of a few days-to-one week the creatine returns to baseline (or close to it) Presentation Physical exam[step2.medbullets.com]
  • […] low: as above medium: Cr 110-130 μmol/L or CrCl high: Cr 130-200 μmol/L or CrCl renal transplant , dehydration or hypotension low: not possible medium: even if their renal function is normal high: Cr 130-200 μmol/L or CrCl 30-60 mL/min Treatment and prognosis[radiopaedia.org]
  • Course Prevention References: [1] [2] [3] [4] [5] [6] Stages Stages of acute kidney injury according to KDIGO There are several classifications for staging AKI and assessing the prognosis.[amboss.com]
  • The histologic classification scheme used in idiopathic AAV to predict clinical prognosis ( 8 ) has not been validated in drug-associated AAV. Figure 1.[cjasn.asnjournals.org]

Etiology

  • While sometimes this is easy and relatively straightforward, often the clinician faces a difficult challenge distinguishing these two etiologies of kidney disease.[ncbi.nlm.nih.gov]
  • Etiology Prerenal ( 60% of cases) Any condition leading to decreased renal perfusion : Hypovolemia (e.g., burns , pancreatitis , diuretics ) Hypotension (e.g., sepsis , dehydration ) Renal vasoconstriction or stenosis (e.g., hepatorenal syndrome ) NSAIDs[amboss.com]
  • Etiology of AKI The etiology of AKI has changed over the last 10-20 years from primary renal disease (hemolytic uremic syndrome, glomerulonephritis) to the renal complications of systemic illness or associated treatment (sepsis, cardiac disease, oncologic[chikd.org]
  • Additional Drug-Induced Etiologies of MN.[cjasn.asnjournals.org]

Epidemiology

  • The new epidemiology of HIV-related kidney disease. J AIDS Clin Res. 2012;S4:1–6. This article describes the changing epidemiology of HIV in both the pre and post- cART era.[springermedizin.de]
  • Addresses the full range of renal problems, from epidemiology to monitoring and diagnostic procedures to pathophysiology of organ systems in relation to kidney failure.[books.google.de]
  • Acute kidney injury: epidemiology and diagnostic criteria. Curr Opin Crit Care . 2006;12:531-537. 7. Bellomo R. The epidemiology of acute renal failure: 1975 versus 2005. Curr Opin Crit Care. 2006;12:557-560. 8.[uspharmacist.com]
  • Introduction Clinical definition acute kidney injury soon (24-48 hours) after contrast media administration Epidemiology incidence dependent on the presence or absence of risk factors among patients with no risk factors, the risk of contrast nephropathy[step2.medbullets.com]
  • Research Research in the epidemiology of DIKD has been limited. The lack of consensus definitions has led to variability in the incidence of DIKD.[bmcnephrol.biomedcentral.com]
Sex distribution
Age distribution

Pathophysiology

  • Its pathophysiological mechanism remains speculative and is possibly modulated according to the risk factor(s) and clinical presentation of the patients.[eurekaselect.com]
  • Addresses the full range of renal problems, from epidemiology to monitoring and diagnostic procedures to pathophysiology of organ systems in relation to kidney failure.[books.google.de]
  • Typical pathophysiological features include glomerular injury, proteinuria, renal fibrosis and inflammatory cell infiltration, making this model attractive as an in vivo drug screening system.[creative-biolabs.com]
  • In this report, we describe a case of crystalglobulin-induced nephropathy and discuss its pathophysiology and the differential diagnosis of paraprotein-induced crystalline nephropathy.[mayoclinic.pure.elsevier.com]
  • Immunosuppressant-induced nephropathy: pathophysiology, incidence and management. Drug Saf . 1999;21(6):471–488. 12. Perazella MA. Drug-induced nephropathy: an update. Expert Opin Drug Saf . 2005;4(4):689–706. 13. Markowitz GS, Perazella MA.[aafp.org]

Prevention

  • Clinical trials for the prevention of CIN have largely employed small oral doses of NAC in stable outpatient populations.[annals.org]
  • The drug had also shown promise in small preliminary studies for the prevention of periprocedural myocardial infarction in patients undergoing coronary stenting.[mdedge.com]
  • Preventive and therapeutic compositions for drug induced nephropathy and hepatitis Info Publication number EP0997150A4 EP0997150A4 EP98907207A EP98907207A EP0997150A4 EP 0997150 A4 EP0997150 A4 EP 0997150A4 EP 98907207 A EP98907207 A EP 98907207A EP 98907207[google.com]
  • AND THERAPEUTIC COMPOSITIONS FOR DRUG INDUCED NEPHROPATHY AND HEPATITIS (FR) COMPOSITIONS PREVENTIVES ET THERAPEUTIQUES POUR NEPHROPATHIES ET HEPATITES D'ORIGINE MEDICAMENTEUSE Abstract: (EN) Novel agents for relieving drug-induced nephropathy and acute[patentscope.wipo.int]
  • Prostaglandin E 1 (PGE 1 , alprostadl), a drug used to treat erectile dysfunction , can safely prevent contrast-induced nephropathy (CIN) in high-risk patients undergoing percutaneous coronary intervention, investigators reported online ahead of print[clinicaladvisor.com]

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