n CME : Your SA Journal of CPD - Drug-induced renal injury : main article

Volume 29, Issue 6
  • ISSN : 0256-2170



The kidney receives a rich blood flow of 25% of resting cardiac output and plays an important role in the elimination of many drugs and their metabolites. The kidney is therefore exposed to high concentrations of drugs and metabolites, making it vulnerable to drug toxicity. It is therefore not surprising that drug-induced renal injury contributes up to 25% of all cases of acute renal failure. Drug-induced renal injury may cause predictable, cumulative dose-dependent toxicity or idiosyncratic dose-independent toxicity at any time during therapy. Cumulative dose-dependent renal toxicity can be anticipated and prevented, but idiosyncratic renal toxicity cannot. A basic understanding of drug-induced renal injury will help to better understand drug-induced renal toxicity and allow for a vigilant approach when prescribing drugs with potential renal toxicity. Renal injury may occur in various renal compartments: the renal vascular supply, the glomerulus, the tubulointerstitium where extensive tubular-peritubular caplliary exchange of solutes takes place, and the collecting ducts.

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