药源性急性肾损伤研究进展

Study Progress of Drug- induced Acute Kidney Injury

药物作为疾病预防、治疗和诊断的重要手段,也是造成急性肾损伤(AKI)的因素之一。肾毒性药物种类繁多,可以是单一药物亦可是多种药物联合应用而致病。药源性AKI发病机制多样,以急性肾小管坏死和间质性肾炎为主。发病的高危因素涉及药物因素(如:药物自身的肾脏毒性、使用剂量与疗程)和患者因素(如:高龄、血容量不足、慢性肾脏病基础)。本文就临床常见及易忽视的肾毒性药物进行综述,旨在提高对肾毒性药物及发生药源性AKI风险因素的认知,为临床用药提供参考与警示。

As an important part of disease prevention, treatment and diagnosis, drugs are the common source of acute kidney injury （AKI）. There are various kinds of nephrotoxic drugs, and AKI can be induced either by a single drug or combination of several drugs. The main mechanisms of drug-induced AKI include acute tubular necrosis and acute interstitial nephritis. The risk factors involve drug-related factors （such as nephrotoxicity, dosage and duration） and patient-related factors （such as age, hypovolemia, chronic kidney disease）. This article is a review of common or unnoticeable nephrotoxic drugs on the purpose of calling for attention to nephrotoxic drugs and AKI risk factors and providing warnings for clinical drug use.