1. Nephrotoxicity
Poisonous effect of some substances both toxic chemicals and medication.
Nephrotoxins are chemicals displaying nephrotoxicity.

2. Renal toxicity can be a result of hemodynamic changes, direct injury to cells and tissues, inflammatory tissue injury, obstruction of renal tubules.

3. Direct tubular effect PCT DCT Tubular obstruction
Aminoglycoside (gentamicin),amphotericin B,cisplatin,
Radio contrast media
DCT
NSAIDs,ACE inhibitors,cyclosporin,lithium salts,cyclophosphamide.
Tubular obstruction
Sulphonamides,methotrexate,triamterene.

4. Acute interstitial nephritis
Beta lactam antibiotics
Vancomycin
Rifampicin
Sulfonamides
NSAIDs

5. Other causes of renal damage
Biologic therapy
Interleukin 2 or interferon alpha
Low BP
Lot of protein in diet
Diabetes mellitus

6. When kidney damage occurs body is unable to rid of excess urine and other wastes. Electrolytes e.g K+, Mg+ are elevated.
Rise of BUN and creatinine
Cause could be dehydration or renal
How diagnosed?
Normal values
Bun ______10-25mg/dl
Creatinine________ mg/dl

7. Nephrotoxic effect of drugs may be added when administered together.
Dose adjustment of drugs is made for drugs which are excreted via kidney if renal function is decreased.