Nephrotoxicity induced by antimicrobial drugs

Abstract

The negative effect of toxic chemicals and drugs on the kidneys leads to nephrotoxicity due to a disturbance of the physiological regulation functions such as the hydro-saline and acid-base equilibrium, detoxification of metabolic intermediates, and elimination of drugs and toxic metabolites. The nephrotoxic effect is more predominant in patients with kidney disease and may be manifested by acute or chronic renal failure with disruption of the processes of filtration, secretion, reabsorption and concentration of urine. The symptoms of kidney failure are various and in most cases depend on the nature of the nephrotoxics. The most common symptoms include azotemia, increased serum urea, hematuria, anemia, proteinuria, albuminuria, acidosis, edema, hepatomegaly, ascites to convulsions, and coma. The range of nephrotoxic substances is quite varied and numerous, and includes: drugs, solvents, pesticides, herbicides, alcohols, fuels, mushrooms, plants. A special aspect is represented by the antimicrobial drugs such as: antibiotics (aminoglycosides, glycopeptides, ansamycins, polymyxins, tetracyclines, cephalosporins, penicillins), sulfamides, fluoroquinolones, antifungals, antivirals etc.