Download Nephrotoxicity

Nephrotoxicity
 Nephrotoxicity is one of the most common kidney
problems and occurs when your body is exposed to a drug
or toxin that causes damage to your kidneys.
 When kidney damage occurs, you are unable to rid your
body of excess urine, and wastes. Your blood electrolytes
(such as potassium, and magnesium) will all become
elevated.
 Symptoms of nephrotoxic injury are wide ranging and,
in some cases, depend upon the type of toxin involved.
 In general, symptoms are similar to those of renal
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failure and include :1- excess urea in the blood (azotemia).
2-increased hydrogen ion concentration in the blood
(acidosis).
3-excess fluids in the body (overhydration).
4- and high blood pressure (hypertension).
 Nephrotoxicity can be temporary with a temporary
elevation of lab values (BUN and/or creatinine)
 1. Blood Urea Nitrogen (BUN)
 2. Creatinine
 1. Blood Urea Nitrogen (BUN)
 Your BUN reflects the amount of nitrogen that is present in your body in
the form of a waste product called urea. BUN is used to determine if there
is extra nitrogenous wastes in your blood stream, which should have been
filtered out of your kidneys.
One of the symptoms of kidney problems is the failure to filter as much
urea as is necessary. An excess of nitrogen compounds in the blood may
lead to uremia.
 2. Creatinine
 The serum Creatinine is present after the chemical Creatine is broken
down by the body in order to make energy for your muscles. The kidneys
are normally able to filter out large amounts of creatinine on a daily basis.
However, when kidney problems are present, your creatinine levels will
increase, reflecting less creatinine being filtered out through the kidneys.
 Normal Values - Kidney Function Tests*
 Blood Urea Nitrogen (BUN)
10-25 mg/dL
 Creatinine
0.7-1.4 mg/dL
 *normal values may vary from laboratory to laboratory
 If these levels are elevated, these may be due to a
temporary condition such as dehydration or you may
be developing renal (kidney failure).
 If the cause of the increased BUN and/or creatinine
levels is determined early, and your healthcare
provider implements the appropriate intervention,
permanent kidney problems may be avoided.
 Nephrotoxicity may also be referred to as renal toxicity.
 Causes Of Elevated BUN and Creatinine Levels:
 There may be a blockage of blood flow to or from the kidney.
This may be caused by kidney stones or a tumor.
 Low blood pressure or irregular heart rhythms may be
preventing blood flow to the kidneys and may produce signs of
kidney problems.
 A urinary infection, or nephritis (inflammation of one or more
of your kidneys)
 You may have had a heart attack or are in congestive heart
failure.
 An enlarged prostate gland in men.
 You may have a bleed in your gastrointestinal tract or stomach
(GI bleed).
 Diabetes mellitus .
 Drug toxicity - risk for kidney problems may be from:
Chemotherapy drugs such :
 Biologic therapy such as interleukin-2, or interferon Alpha.
 Antibiotics (such as Amphotericin B, Gentamycin and Vancomycin
 Angiotensin-Converting Enzyme (ACE) Inhibitors - used in heart
failure or after a heart attack. ACE inhibitors are given to diabetics with
mild kidney disease
 Non-steroidal Anti-inflammatory Drugs (NSAID's like Ibuprofen)
 Some diuretics - such as Furosemide - may cause kidney failure
 Other drugs may cause temporary elevations in BUN and/or Creatinine.
*If you are at risk for developing kidney failure, your healthcare
provider will monitor you closely for nephrotoxicity symptoms of other
kidney problems.