Drug-Induced kidney disease Flashcards
What medications affect PGs and Ang II causing prerenal AKI?
- ACEi/ARBs
- NAIDs
- Cyclosporine
- Tacrolimus
How do NSAIDs cause low GFR?
- decrease in vasodilatory PGs
- Ang II compensated by increasing constriction and vascular resistance on efferent side
- low GFR both sides constrcited
How do ACEi/ARBs cause low GFR?
- decrease in Ang II on efferent side–> vasodilation
- increased PGs on the efferent side
–> vasodilation - low GFR both sides dilated
What is acute tubular necrosis? How does is lead to intrinsic AKI?
- direct damage to proximal and distal tubular cells from ischemic/toxic insult
- cells die and slough off leading to obstruction and increased intraluminal pressure, which reduces globular filtration
What medications can cause acute tubular necrosis?
- aminoglycosides
- radiographic contrast dyes
- cisplatin
- amphotericin
What drug class is most likely to cause acute allergic interstitial nephritis?
Diuretics
What is chronic interstitial nephritis?
progressive and irreversible lesion due to offending agents
What drugs cause chronic interstitial nephritis?
- Lithium
- Cyclosporine (long-term use)
- Tacrolimus (long-term use)
What drug class can cause papillary necrosis? How does this happen?
- Analgesics
- decreased blood supply with oxygen (nephropathy)
What drug is most likely to cause minimal change glomerular disease?
Lithium
What drugs are most likely to cause focal segmental glomerulosclerosis?
- heroin
- Lithium
What can cause membranous nephropathy?
Gold therapy
What medication is most likely to cause renal vasculitis?
Hydralazine (chronic use)
What medication is most likely to cause thrombotic microangiopathy?
oral contraceptives
What is most likely to cause cholesterol emboli (purple toe syndrome)?
warfarin
