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[药物性肾病]

[Drug-induced nephropathies].

作者信息

Fillastre J P, Dhib M, Godin M, Moulin B

机构信息

Service de Néphrologie, Hôpital de Bois-Guillaume.

出版信息

Ann Med Interne (Paris). 1989;140(7):600-4.

PMID:2610454
Abstract

The list of nephrotoxic drugs is long. The kidney is particularly susceptible to the nephrotoxic action of drugs, because of its functional properties, including: a) the high volume of renal blood flow, which brings large amounts of toxin; b) the large area in contact with the drug, either in the glomerulus or the tubule epithelium, which enables toxin interaction or uptake; c) the kidney's ability to transfer active substances, which provides specific transfer mechanisms that mediate cellular uptake; d) drug breakdown, which may occur in renal tubules and lead to the formation of toxic metabolites from non-toxic parent substances; e) the kidney's concentrating mechanisms, which can increase urinary and interstitial concentrations of non-absorbed products; f) the high metabolic rate of tubule cells required for normal function, which is subject to perturbation. Indeed, nephrotoxins affect every aspect of renal pathology, from acute renal failure due to functional alterations to that resulting from tubule cell necrosis. These anomalies may occur suddenly or after a long period of exposure to the toxic agent. They may be localized in the cortex or the medulla and affect all parts of the nephron: the glomeruli, the tubules, the interstitium or the vessels. How then is the topic of a brief expose to be chosen? It was made based upon the results of a questionnaire addressed to French nephrologists.

摘要

具有肾毒性的药物种类繁多。由于其功能特性,肾脏特别容易受到药物肾毒性作用的影响,这些特性包括:a) 肾血流量大,会带来大量毒素;b) 在肾小球或肾小管上皮与药物接触的面积大,这使得毒素能够相互作用或被摄取;c) 肾脏转运活性物质的能力,这提供了介导细胞摄取的特定转运机制;d) 药物分解,这可能发生在肾小管中,并导致无毒母体物质形成有毒代谢产物;e) 肾脏的浓缩机制,可增加未吸收产物的尿液和间质浓度;f) 正常功能所需的肾小管细胞高代谢率,这容易受到干扰。事实上,肾毒素会影响肾脏病理学的各个方面,从功能改变导致的急性肾衰竭到肾小管细胞坏死导致的急性肾衰竭。这些异常情况可能突然出现,也可能在长期接触有毒物质后出现。它们可能局限于皮质或髓质,并影响肾单位的所有部分:肾小球、肾小管、间质或血管。那么,如何选择简短阐述的主题呢?它是根据向法国肾脏病学家发放的一份调查问卷的结果选定的。

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