Nephrotoxicity is kidney damage caused by chemical exposure, including drugs, toxins, and naturally occurring compounds. Diagnosis involves blood tests and imaging, and treatment includes adjusting medication and dialysis. Monitoring and safety controls are important to prevent exposure to nephrotoxic substances.
Nephrotoxicity refers to kidney damage caused by chemical exposure. Some drugs can damage the kidneys when administered in high concentrations or over a long period of time, and nephrotoxic compounds also occur in nature and in manufacturing settings. If patients are not treated, they can develop kidney failure, losing the ability to filter blood and produce urine. This can quickly become fatal.
The definitive way to diagnose nephrotoxicity is with a blood test to check levels of certain compounds, such as creatinine and blood urea nitrogen (BUN). If these are elevated, it suggests that kidney function may be impaired. Imaging of the kidneys may reveal a change in size, such as significant swelling or shrinkage, which indicates that the kidneys are damaged. Once nephrotoxicity has been identified, the next step is to determine the cause so it can be treated.
Many drugs can cause nephrotoxicity by disturbing the cardiovascular system or the kidneys themselves. This is a known side effect that can be taken into consideration when balancing the risks of various treatment options. Patients taking these drugs may need to be monitored to assess kidney function so that the treatment plan can be changed if the patient’s kidneys start to become strained. For people who already have reduced kidney function, a doctor may recommend a kidney dose adjustment, reducing the amount of medications used to limit the strain on the kidneys.
Some poisons and toxic chemicals can also cause nephrotoxicity. These are not designed to be ingested, but patients can be exposed to them due to poor safety controls, deliberate introduction into the environment, or lack of experience. In these cases, patients may develop symptoms of kidney damage such as increased or decreased urination, changes in urine color, and abdominal pain. A blood test can show that nephrotoxicity has occurred and the patient can receive treatment. This may include dialysis to safely remove toxins from the body.
Some naturally occurring compounds, such as plants and fungi, have the potential to be nephrotoxic. This can be designed as a defense or could be a byproduct of another biological process. Their consumption can make organisms very ill, especially if they are eaten in large quantities. This can be a problem with animals such as cattle, which may graze freely on any plants they see, even if some are toxic. If a herd is not monitored closely, more cows could become ill or die before the problem is identified.
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