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Nephrotoxicity
N/A
53
Agriculture
4th Grade
02/08/2013

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Term
Reduced renal perfusion (prolonged vasoconstriction; shock or hemorrhage)
Definition
Hemodynamic renal failure
Term
Inflammation of the renal tubules and the interstitial tissue between the glomerulus and the tubules
Definition
Acute interstitial nephritis (AIN)
Term
Most common cause of acute renal failure
Definition
Acute tubular necrosis (ATN)
Term
May be caused by specific problems with the body's immune system, but the precise cause of most cases is unknown
Definition
Glomerulonephritis
Term
Renal dysfunction due to a structural or functional hindrance of normal urine flow
Definition
Obstructive nephropathy
Term
decreased renal blood flow, decreased glomerular filtration rate --> ischemia
Definition
Prolonged vasoconstriction
Term
decreased blood pressure, decreased blood flow --> ischemia
Definition
Shock or hemorrhage
Term
ACEIs, ARBs, Aspirin, Ibuprofen
Definition
cause hemodynamic failure
Term
prevents conversion of angiotensin I to angiotensin II
Definition
ACE inhibitors
Term
blocks angiotensin II receptor
Definition
ARB
Term
renin-angiotensin-aldosterone cycle inhibition
Definition
causes vasodilation, decreasing perfusion pressure and decreasing glomerular filtration --> ARF
Term
causes hemodynamic acute renal failure especially in patients with pre-existing renal artery stenosis
Definition
renin-angiotensin-aldosterone cycle inhibition
Term
inhibition of cyclooxygenase
Definition
block prostaglandin synthesis
Term
facilitating renin secretion, vasodilation of the afferent arteriole and regulation of sodium excretion
Definition
role of prostaglandins
Term
can be nephrotoxic in patients with borderline renal function. renal arterial stenosis, hypovolemia, sepsis, severe chronic heart failure and kidney disease
Definition
NSAIDs
Term
accounts for up to 15% of hospital admissions for acute renal failure
Definition
acute interstitial nephritis
Term
AIN: most common culprit are NSAIDs but other drugs are also implicated
Definition
Acetaminophen, Beta Lactam antibiotics
Term
ATN: most frequent cause is ischemic tubular necrosis caused by failure of renal perfusion as a result of:
Definition
prolonged hypotension, hypovolemic shock, excessive blood loss
Term
Induce injury to proximal convoluted tubules
Definition
Antibiotics (aminoglycosides, amphotericin B); NSAIDs
Term
Is NOT associated with prominent tubular inflammation
Definition
Acute tubular necrosis
Term
bind to phospholipids in the mitochondrial and lysosomal membranes of proximal convoluted tubular cells
Definition
Aminoglycosides (Gentamicin, Karamycin, etc)
Term
Aminoglycosides can be detected by monitoring this
Definition
serum creatinine
Term
Occurs in 80% of patients after a cumulative dose of 3-4 grams
Definition
Amphotericin B- induced acute tubular necrosis
Term
affect both proximal and distal convoluted tubules to increase permeability, increase oxygen requirements and cause vasoconstriction
Definition
Amphotericin B
Term
most common cause of nephritic syndrome in children
Definition
Minimal change disease (MCD)
Term
Minimal change disease (Nephrotic syndrome)
Definition
caused by NSAIDs, Rifampin and other drugs
Term
Nephrotic Syndrome (Glomerulonephritis)
Definition
Minimal change disease; Focal segmental glomerulosclerosis; Thin basement membrane nephropathy; membranoproliferative glomerulonephritis
Term
regionalized scarring of glomerulus caused by heroin; most common cause of nephritic syndrome in adults
Definition
Focal segmental Glomerulosclerosis (FSGS)
Term
Most common cause of asymptomatic hematuria (blood in urine)
Definition
Thin Basement Membrane Nephropathy (TBMN)
Term
Thin Basement Membrane Nephropathy
Definition
Caused by NSAIDs, Mercury, Penicillamine, Gold therapy
Term
Immune deposits in intraglomerular mesangium caused by hydralazine (Apresoline)
Definition
Membranoproliferative glomerulonephritis (MPGN)
Term
Categories of obstructive nephropathy
Definition
Urate nephropathy; Drug-induced crystalluria; Retroperitoneal Fibrosis
Term
crystallization of urate and drugs within the renal tubules
Definition
direct interstitial toxicity
Term
crystal and stone formation within the ureteres
Definition
obstructive nephropathy
Term
Tumor lysis syndrome (cancer patients) in which uric acid is cleared by renal excretion
Definition
Urate nephropathy
Term
presence and excretion of rather insoluble metabolic products in crystalline form in urine
Definition
Drug-induced crystalluria
Term
associated with crystalluria, especially during dehydration (may cause obstructive nephropathy)
Definition
sulfonamides; ciprofloxacin
Term
caused by proliferation of fibrous tissue in the retroperitoneum which may prevent the ureters from carrying urine from the kidney to the urinary bladder
Definition
Retroperitoneal fibrosis
Term
Retroperitoneal fibrosis
Definition
in most cases occurs as an idiosyncratic type B adverse drug reaction
Term
Retropreitoneal fibrosis is a recognized complication of these
Definition
ergot derivatives, methotrexate, and other drugs
Term
heart failure as a risk factor for nephrotoxicity
Definition
decreased cardiac output = decreased blood flow to the kidney = reduced renal perfusion
Term
reduced renal function is result of nephrotoxic drugs
Definition
hemodynamic renal failure
Term
adjacent to glomerulus; increases release of renin when blood volume is decreased/decrease in renal perfusion
Definition
juxtaglomerular apparatus
Term
renin's natural polypeptide that is released from the liver and reduced from 12 peptides to 10 and then to 8
Definition
angiotensinogen
Term
is the most active member of the angiotensin family
Definition
Angiotensin II
Term
Angiotensin II stimulates adrenal cortex to release this to act on kidney and increase reabsorption of sodium ion and chloride ion (and promotes excretion of potassium ion)
Definition
Aldosterone
Term
Angiotensin II is a potent vasoconstrictor
Definition
BP increases and more water retention and increased salt in body= increased blood volume = greater perfusion of juxtaglomerular apparatus = inhibition further release of renin
Term
after long use of ACEIs and ARBs
Definition
reduced renal blood flow= reduced glomerular filtration rate = ischemia of kidney; kidney will still release renin but renin won't work b/c of the drugs being used
Term
precursor to all prostaglandins
Definition
arachidonic acid
Term
acute interstitial nephritis (AIN)
Definition
intense inflammation of nephron tubules
Term
happens BEFORE blood gets to kidney. (low blood pressure and/or blood loss)
Definition
Hemodynamic
Term
are all intrinsic classes of nephrotoxicity
Definition
AIN, ATN, and glomerular nephropathy
Term
POST kidney; they affect the kidney but also affect the ureters (interfere with flow of urine)
Definition
Obstructive nephropathy (urate nephropathy, crystalluria, retroperitoneal fibrosis)
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