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Toxicology > Kidney Toxicity > Flashcards

Kidney Toxicity Flashcards

1
Q

Acute Kidney Injury criteria: (3)

A

Increase serum creatine to 1.5 times baseline

Decreased urine volume

Decreased in eGFR

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2
Q

Biomarkers of kidney toxicity

A
  1. urinary proteins with enzymatic activities
  2. Proteinuria
  3. Kidney injury molecule (KIM-1)
  4. Neutrophil gelatinase-associated lipocalin (NGAL)
  5. Cytokines
  6. Clusterin
  7. Type IV collagen
  8. Osteopontin
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3
Q

Chronic kidney disease symptoms

A

decreased eGFR

increased albumin: creatine ration

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4
Q

how many % of cardiac output does kidney receive?

A

20-25%

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5
Q

Three toxic form of Hg

A

Elemental, Organic, Inorganic

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6
Q

Absorbed by lugs following inhalation, can cross blood brain barrier

A

Element mercury

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7
Q

after absorption, accumlates in kidney

A

Inorganic mercury

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8
Q

most readily absorbed, distributes especially to the brain

A

Organic mercury

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9
Q

How does binding of Hg occur in the body?

A

divalent mercuric ion (Hg2+) binds to sulfhydryl group in protein (-SH)

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10
Q

Toxic effects of mercury

A
  1. Increase oxidatve stress
  2. Disruption of microtubule formation
  3. Interference with protein synthesis
  4. Interference with DNA replication
  5. Interference with Ca homeostasis
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11
Q

Example of Halogenated hydrocarbon

A

CCl3

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12
Q

Halogenated hydrocarbon toxicity mechanisms

A

linked to its metabolism by renal cytochrome P450.

Formation of reactive intermediate which binds covalently to nucleophilic groups on cellular macromolecules

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13
Q

most reported poisoning cases among analgesics

A

Acetaminophen

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14
Q

Nephrotoxicity of Acetaminophen

A
  1. Proximal tubular necrosis
  2. Increases in blood urea level and plasma creatine
  3. Decreases in GFR and clearance of para-aminohippurate
  4. Increases in the fractional excretion of water, sodium and potassium
  5. Increases in urinary glucose, protein, and brush border enzymes
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15
Q

Antidote of acetominophen

A

N-acetylcysteine

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16
Q

Cytochrome P450 oxidation pathway will produce _____ which is a toxic intermediate

A

NAPQI

17
Q

Examples of NSADIS

A

ibuprofen, naproxen, indomethacin, cyclooxygenase-2 inhibitors

18
Q

Mechanisms of NSAIDs toxicity

A

Inhibition of prostaglandin synthesis and results in vasoconstriction which leads to reduced renal blood flow.

19
Q

Nephrotoxicity antibiotics

A

Aminoglycoside

20
Q

Example of aminoglycoside

A

Gentamycin

21
Q

Aminoglysocide used for gram ___ bacteria

A

negative

22
Q

Mechanisms of gentamycin toxicity

A

Filtered in the glomerulus and entered the tubular lumen

Taken up by proximal tubular cells and in vesicles

Fused with lysosomes inside the cell

Destabilising lysosomes, causing it to rupture and release its hydrolytic enzymes which cause damage within the cell

Gentamycin also can cause direct damage on mitochondria

Toxicology (8 decks)

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