DRUG-INDUCED RENAL-DISEASE

Objective: To review drug-induced renal disease with emphasis on current issues and practical problems with commonly used agents. Data sources: English language literature search using MEDLINE, index Medicus, textbook articles and relevant reviews. Study selection: Drugs in common use were reviewed in detail. Uncommonly used drugs or those with only a few reports of nephrotoxicity were excluded from this review. Data synthesis: The clinical patterns of nephrotoxicity include an episode of acute deterioration of renal function, chronic renal failure and proteinuria which may be severe enough to cause the nephrotic syndrome. Diagnosis is made by clinical suspicion, distinctive clinical patterns and usually improvement in renal function on drug withdrawal. Conclusion: A high index of suspicion is necessary to detect drug-induced renal disease particularly with increasing availability of over-the-counter drugs. Drugs should always be suspected of causing renal disease where no alterative cause is obvious. When any doubt exists the agent in question should be withdrawn.