The 6R's of drug induced nephrotoxicity

BMC Nephrol. 2017 Apr 3;18(1):124. doi: 10.1186/s12882-017-0536-3.

Abstract

Drug induced kidney injury is a frequent adverse event which contributes to morbidity and increased healthcare utilization. Our current knowledge of drug induced kidney disease is limited due to varying definitions of kidney injury, incomplete assessment of concurrent risk factors and lack of long term outcome reporting. Electronic surveillance presents a powerful tool to identify susceptible populations, improve recognition of events and provide decision support on preventative strategies or early intervention in the case of injury. Research in the area of biomarkers for detecting kidney injury and genetic predisposition for this adverse event will enhance detection of injury, identify those susceptible to injury and likely mitigate risk. In this review we will present a 6R framework to identify and mange drug induced kidney injury - risk, recognition, response, renal support, rehabilitation and research.

Keywords: Acute kidney injury; Adverse reaction; Crystalluria; Drugs; Glomerular; Hypersensitivity; Nephrolithiasis; Nephrotoxicity; Tubular toxicity.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / therapy
  • Biomedical Research
  • Drug-Related Side Effects and Adverse Reactions / diagnosis
  • Drug-Related Side Effects and Adverse Reactions / etiology*
  • Drug-Related Side Effects and Adverse Reactions / therapy
  • Humans
  • Renal Replacement Therapy
  • Risk Assessment
  • Severity of Illness Index