Acute kidney injury due to antimicrobial therapy

Vnitr Lek. 2022 Fall;68(4):227-233.

Abstract

One of the common causes of acute kidney injury (AKI) is drug nephrotoxicity. A large group of drugs associated with AKI includes a considerable number of antimicrobials. Clinical manifestations range from mild forms of tubular damage to significant deterioration of renal function requiring renal replacement therapy. Several mechanisms have been described, although the most common are acute interstitial nephritis, acute tubular necrosis, crystalic nephropathy or proximal/distal tubulopathy with electrolyte abnormalities. General risk factors for antimicrobial-induced AKI include pre-existing chronic kidney disease and concomitant use of drugs with nephrotoxic potential. Prevention and early recognition of AKI are the standard approach to mitigate AKI and avoid morbidity.

Keywords: Vancomycin; acute kidney injury; aminoglycosides; antibiotics.

MeSH terms

  • Acute Kidney Injury* / etiology
  • Anti-Bacterial Agents / adverse effects
  • Electrolytes / adverse effects
  • Humans
  • Kidney
  • Nephritis, Interstitial* / chemically induced
  • Nephritis, Interstitial* / complications
  • Renal Insufficiency, Chronic* / complications

Substances

  • Anti-Bacterial Agents
  • Electrolytes