Schwarz A
Medizinische Klinik des Universitätsklinikum, Benjamin Franklin, Berlin.
Z Arztl Fortbild (Jena). 1996 May;90(3):205-12.
Drug-related renal damage is manifold in its origin, clinical picture and prognosis. The disorder can manifest itself as a purely functional phenomenon with tubular elimination of amino acids, enzymes, protein, glucose and electrolytes, or it is due to reversible hemodynamic changes; on the other hand, it may be accompanied by cell necrosis and inflammation. Hemodynamic, toxic, immunologic, or mechanically obstructive mechanisms or a combination of these play a pathogenetic role. It is important to know the renal parameters before and monitor them during treatment with nephrotoxic drugs; to avoid concomitant administration of two or more nephrotoxic drugs; and to make the diagnosis as well as terminate exposure rapidly.
药物相关的肾损害在病因、临床表现和预后方面具有多样性。该病症可表现为单纯的功能性现象，即肾小管对氨基酸、酶、蛋白质、葡萄糖和电解质的排泄异常，或者是由于可逆的血流动力学改变所致；另一方面，它可能伴有细胞坏死和炎症。血流动力学、毒性、免疫或机械性梗阻机制或这些机制的组合在发病过程中起作用。在用肾毒性药物治疗前了解肾脏参数并在治疗期间进行监测很重要；避免同时使用两种或更多种肾毒性药物；并迅速做出诊断并终止药物暴露。
