Kidney specific factors that enhance nephrotoxic risk are noted.

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Presentation transcript:

Kidney specific factors that enhance nephrotoxic risk are noted. Kidney specific factors that enhance nephrotoxic risk are noted. First, high RBF increases drug delivery to the kidney. High metabolic rates of cells increase risk for nephrotoxicity with certain drugs. Renal biotransformation of drugs to toxic metabolites and ROS overwhelms local anti-oxidants. Increased concentration of drugs in the medulla and interstitium causes nephrotoxicity. Finally, apical uptake of certain drugs (aminoglycosides, sucrose) and basolateral transport of drugs through the OAT (tenofovir) and OCT (cisplatin) transporters increases renal toxicity. Abbreviations: RBF, renal blood flow; OAT, organic anion transporter; OCT, organic cation transporter; ROS, reactive oxygen species. Mark A. Perazella CJASN 2009;4:1275-1283 ©2009 by American Society of Nephrology