药物性肾损伤的诊治进展

Progress of the diagnosis and treatment of drug-induced renal injury

药物性肾损伤在临床用药中十分常见,是急性肾损伤的一个重要原因,早期发现多数可以逆转。许多药物通过一种或者多种不同的机制引起不同程度的肾脏损伤,导致肾小管间质性、肾小球性和肾血管性疾病。临床上不仅要了解药物的潜在肾毒性,更要认识到患者的危险因素,要及时纠正或避免用药。研究药物性肾损伤的机制对于临床药物的合理应用、早期发现以及有效防治药物的不良反应极其重要。

Drug-induced renal injure is very common in clinical practice.It is an important cause of renal injury,which is reversible when detected early.Various drugs can injure the kidney,but they cause renal injury via only a few common mechanisms including tubulointerstitial,glomerular and renal vascular disease.It is particularly important not only to know the nephrotoxic potential of the different drug groups,but especially to recognize the patient＇s risk factors that could be modified or that should preclude the use of these drugs the first place.To investigate the mechanism of drug induced renal injure is important for reasonable drug usage,early discovery and effective prevention or treatment of adverse effects in clinics.We review the mechanisms,clinical manifestation,diagnosis and prevention of drug-induced renal injure.