Acute kidney injury and 'nephrotoxins': mind your language

Clin Med (Lond). 2018 Oct;18(5):384-386. doi: 10.7861/clinmedicine.18-5-384.

Abstract

The introduction of the term 'acute kidney injury' (AKI) along with an international classification scheme,1 caused some initial confusion, but most clinicians and many patients now understand that the term 'injury' denotes damage to the internal workings of the kidney, rather than physical trauma. However, of greater concern is the use of the term 'nephrotoxic' to include drugs that are, in most settings, nephroprotective. We argue that this imprecise terminology, unfortunately adopted by the National Institute for Health and Care Excellence (NICE) among others, is potentially harmful, and that the terms 'nephrotoxin' and 'nephrotoxic' should not be used to describe haemodynamically mediated and fully reversible effects of some drugs on excretory function.

Keywords: ACEI; ARB; Acute kidney injury; nephrotoxins.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury* / chemically induced
  • Acute Kidney Injury* / diagnosis
  • Acute Kidney Injury* / drug therapy
  • Acute Kidney Injury* / physiopathology
  • Angiotensin Receptor Antagonists / adverse effects
  • Angiotensin Receptor Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Humans
  • Noxae / toxicity*

Substances

  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Noxae