What are the main symptoms of drug induced renal injury? What are the common medications?

Drug-induced kidney damage is also a term we hear for every condition. So what are the symptoms of his presentation? <>

Drug-induced kidney damage may present differently in different patients, for example, some patients do not have any symptoms in the early stage of drug-induced kidney damage. It will only be in the middle and late stages that there will be some abnormal performance. And there are some patients, he will react more early on.

For example, some patients may have foam or blood in their excrement, and may also have backache. Other patients present with oliguria or edema. Then there are patients who show symptoms such as allergies, such as rashes.

There are also early symptoms of sleep problems, such as restless sleep at night, dreaming, and frequent awakenings. In addition, it is often easy to get tired, and there may be constipation, and if it is severe, it may also be pale, cold limbs, frequent cold sweats, blood pressure drops, anemia, etc. In general, patients will have pain and edema, and the lower back pain is the most common.

So, what are the drugs for drug-induced kidney damage? The first is glucocorticoids. However, whether to let the patient drink glucocorticoids depends on the specific situation of the patient, if the symptoms of drug-induced renal damage are relatively mild, that is, in his early stage, there is no need to take glucocorticoids.

However, if the symptoms are particularly severe, and it is in the middle and late stages, it is necessary to take this glucocorticoid to **. The second is to take some Kidney Failure Ning capsules, which can effectively alleviate the condition and is better for the body.

In addition to drug-induced **, for patients with drug-induced kidney damage, it is necessary to exercise more, eat more fresh vegetables and fruits, pay attention to a balanced diet, drink more water, and eat more foods with high protein content, so as to effectively help the condition.

Some patients are asymptomatic and insensible, some patients find an increase in urine output or a small amount of blood in the urine or even a little backache, and some patients may have allergies and rashes. In severe cases, these patients may experience symptoms such as oliguria and even edema. The drugs involved in drug-induced kidney injury are mainly nonsteroidal anti-inflammatory drugs, aminoglycoside antibiotics, and penicillin and cephalosporin antibiotics.

Answer]: a, b, c, d, e

The clinical manifestations of nephrotoxicity vary, and severe cases can cause renal failure. Acute renal failure can manifest as a rapid and progressive decline in renal function in a short period of time after taking medication, accumulation of waste products in nitrogen metabolism and electrolyte disorders, and oliguria or anuria, or non-oliguric abrupt acute renal failure. It is often accompanied by renal diabetes, hypotonic urine, and low specific gravity urine.

Renal tubular acidosis may include proteinuria, red blood cells, white blood cells, granular casts in the urine, and elevated urine nagase and lysozyme. It can also evolve into chronic renal insufficiency, and patients can see dizziness, headache, drowsiness, fever, general edema, palpitation and shortness of breath. Some patients also have extrarenal manifestations, such as nausea, vomiting, epigastric discomfort, liver damage, and bone marrow hematopoietic inhibition such as anemia and thrombocytopenia.

In patients with chronic renal failure, the early clinical symptoms are not obvious, the blood biochemical test indexes are mostly normal, and the serum creatinine and urea nitrogen are usually high or slightly elevated in the normal range. At this time, if you continue to use nephrotoxic traditional Chinese medicine, it will aggravate the damage of the kidney and plum organs, which can lead to the gradual occurrence of azotemia, elevated blood creatinine and urea nitrogen, and impaired renal concentration ability, manifested as polyuria, frequent urination and increased nocturia, and mild anemia, urine laboratory tests show renal urine glucose and mild proteinuria, low specific gravity and low osmotic pressure urine. Therefore, ABCDE should be selected for this question.

1 Many antimicrobial drugs are mainly excreted in the human body through the kidneys, and some antibacterial drugs are nephrotoxic. For example: aminoglycosides, tetracyclines, vancomycin, itraconazole intravenous injection, terbinafine, amphotericin B, etc.

2. Kidney damage caused by non-steroidal anti-inflammatory drugs includes: acute tubular necrosis, acute interstitial nephritis, acute renal failure, nephrotic syndrome, chronic interstitial nephritis, etc. Therefore, high-dose and long-term medication should be avoided, such as aspirin, diclofenac sodium, ibuprofen, indomethacin, etc.

3. With the popularization of medical methods such as enhanced CT and interventional **, iodine-containing contrast agents have been widely used, which directly cause a decrease in renal perfusion volume by constricting renal blood vessels, damaging renal tubular epithelial cells, and penetrating nephropathy leading to acute tubular necrosis. Some research results suggest that the chance of non-ionic contrast agents causing presegmental renal damage is significantly lower than that of ionic contrast agents, and contrast agents that are easy to cause kidney damage, such as gastrografin and iohexol.

4 With the development of medicine, the use of immunosuppressants has gradually increased, and the nephrotoxicity of various immunosuppressants has gradually been recognized and valued, and drugs that have obvious constriction of renal blood vessels and cause kidney damage, such as: tacrolimus, cyclosporine A, rapamycin, etc. The main method for preventing nephrotoxicity of cyclosporine and tacromos is to monitor the blood concentration of the drug, and at the same time, pay attention to drug-drug interactions.

5. The nephrotoxicity of methotrexate mainly occurs when taking high doses, which is caused by the large deposition of methotrexate and its metabolite 7-hydroxymethotrexate in the distal renal tubules, resulting in clinical hematuria and acute renal failure. Cisplatin kidney damage usually occurs after 10 days of medication, and the clinical manifestations are: acute kidney damage.

Other drugs with renal impairment such as selmostine, mitomycin, 5-fluorouracil, cyclophosphamide, etc.

6Carbamazepine, phenytoin, valproate, lithium, etc.

7. Furosemide, mannitol, captopril, immunoglobulin, low fraction of dextran, famotidine, allopurinol, benzbromarone, etc. Therefore, when using the above drugs, we must pay attention, especially for patients with renal insufficiency, some drugs need to be regularly monitored for blood drug concentration and dose adjustment, and some need to regularly check kidney function to avoid damage to nephrophilan.

(1) Antimicrobial drugs. Amphotericin B, neomycin, pioneer mycin, gentamycin, kanamycin, streptomycin, tobramycin, polymyxin, vancomycin, penicillin G, neopenicillin, neopenicillin, ampicillin, carbenicillin, tetracycline, oxytetracycline, pioneeramycin, pioneermycin, pioneermycin, lincomycin, sulfonamides, etc.

2) Antipyretic analgesics. Almost all antipyretic analgesics have potential toxicity to the kidneys, especially phenacetin, aspirin, acetaminophen, aminopyrine, and phenylbutazone.

3) Anti-tuberculosis drugs. rifampicin, sodium p-aminosalicylate, ethambutol, etc.

4) Antiepileptic drugs. Trimethyldione, phenytoin, etc.

5) Diuretics. Mercury diuretics, thiazide diuretics such as diuretics, and osmotic diuretics such as mannitol.

6) Anticancer drugs. Cisplatin, mitomycin, pukamycin, methotrexate, 5-fluorouracil, etc.

7) Various angiography agents.

8) Other medicines. Furazolidone, furazandine, cold, cimetidine, etc.

Hello: 1. Gastrointestinal manifestations are the earliest and most common symptoms of uremia. In the early stage, the main complaints were anorexia and abdominal discomfort, and later nausea, vomiting, diarrhea, glossitis, urine odor in the mouth, ulceration of the oral mucosa, and even gastrointestinal bleeding.

2. Mental and nervous system manifestations Mental malaise, fatigue, dizziness, headache, memory loss, insomnia, numbness in the limbs, burning pain in the hands and feet, and even unbearable itching in the lower limbs, must move frequently, can not rest, etc., drowsiness, irritability, delirium, muscle tremors and even convulsions, convulsions, coma may occur in the late stage.

3. Cardiovascular system manifestations often have elevated blood pressure, long-term hypertension will cause left ventricular hypertrophy and enlargement, myocardial damage, heart failure, retained toxic substances will cause myocardial damage, uremic pericarditis.

4. Hematopoietic manifestations Anemia is a necessary symptom of uremia patients. In addition to anemia, there are also easy bleeding, such as subcutaneous ecchymosis, epistaxis, bleeding gums, black stool, etc.

Drug-induced renal impairment is the damage caused by drugs to the kidneys, with the following clinical manifestations:

First of all, tubular injury is a common manifestation of drug-induced renal damage, which is mainly manifested by swelling, shedding and apoptosis of renal tubular epithelial cells.

Drug-induced renal impairment manifests as acute tubular injury when the degree of injury is mild, and acute tubular necrosis when the injury is severe.

Secondly, acute interstitial nephritis, this drug-induced kidney damage generally presents with symptoms such as rash, arthralgia, and fever. Some patients may also experience enlarged kidneys and tubular damage.

At the same time, drug-induced renal damage can also cause acute renal failure, and drugs that are easy to cause this type of drugs include anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, cyclosporine A, etc.