Kidney factors that enhance risk for drug-induced nephrotoxicity.

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Presentation transcript:

Kidney factors that enhance risk for drug-induced nephrotoxicity. Kidney factors that enhance risk for drug-induced nephrotoxicity. High RBF increases drug delivery and exposure to the kidney. High metabolic rates of TALH tubular cells increase risk for drug nephrotoxicity. Kidney metabolism of drugs to toxic metabolites and ROS overwhelms local antioxidants and promotes tubular injury. Increased concentrations of potentially nephrotoxic drugs in the medulla and interstitium increase kidney injury. Apical uptake of certain drugs (aminoglycosides, hydroxyethyl starch) and basolateral transport of drugs through the organic anion transporter (tenofovir) and organic cation transporter (cisplatin) increase kidney toxicity. PCT, proximal convoluted tubule; RBF, renal blood flow; ROS, reactive oxygen species; TALH, thick ascending loop of Henle. Mark A. Perazella CJASN 2018;13:1897-1908 ©2018 by American Society of Nephrology