Munuaistoksuus

Munuaistoksuus refers to damage to the kidneys caused by toxic substances. These substances can be exogenous, meaning they are introduced into the body from external sources, or endogenous, meaning they are produced within the body as byproducts of normal metabolic processes.

Exogenous nephrotoxins include a wide range of agents. Certain medications, such as some antibiotics (e.g., aminoglycosides), nonsteroidal anti-inflammatory drugs (NSAIDs), and chemotherapy agents, can be nephrotoxic if taken in high doses, for prolonged periods, or in individuals with pre-existing kidney conditions. Heavy metals like lead, mercury, and cadmium can also accumulate in the kidneys and cause damage. Contrast agents used in medical imaging, particularly in individuals with impaired kidney function, pose a risk. Plant-derived toxins and venoms from certain animals can also affect kidney health.

Endogenous nephrotoxins arise from internal processes. For example, in conditions like rhabdomyolysis, the breakdown of muscle tissue releases myoglobin, which can overwhelm the kidneys and lead to acute kidney injury. In severe infections or sepsis, toxins produced by bacteria or the body's inflammatory response can damage kidney cells. Metabolites from certain diseases, such as excess uric acid in gout or abnormal proteins in multiple myeloma, can also contribute to kidney toxicity.

The mechanisms of nephrotoxicity are varied and can involve direct cellular damage, interference with kidney blood flow, obstruction of renal tubules, or triggering inflammatory responses within the kidneys. Symptoms of munuaistoksuus can range from subtle changes in kidney function tests to overt signs of acute kidney injury, such as reduced urine output, swelling, and fatigue. Diagnosis involves assessing kidney function, identifying the causative agent, and evaluating the extent of damage. Treatment focuses on removing the toxic substance, supporting kidney function, and managing complications. Prevention often involves careful medication use, avoiding exposure to environmental toxins, and prompt management of underlying conditions.