Nefroprotektiva

Nefroprotektiva refers to a set of measures aimed at preserving kidney function by preventing or mitigating acute kidney injury and slowing the progression of kidney disease in at-risk patients. The term encompasses both nonpharmacologic approaches and pharmacologic strategies designed to reduce renal injury across various clinical contexts, including exposure to nephrotoxins, major surgery, sepsis, and diagnostic procedures such as contrast-enhanced imaging.

Preventive strategies focus on risk assessment, optimization of hemodynamics, and minimizing nephrotoxic exposures. In practice this includes ensuring adequate hydration before and after procedures, selecting safer contrast agents when imaging is necessary, and adjusting or avoiding nephrotoxic medications or reducing their doses in patients with reduced kidney function.

Pharmacologic measures with nephroprotective intent have been studied, such as hydration regimens with isotonic saline or bicarbonate-based solutions, and antioxidants like N-acetylcysteine; however robust and consistent evidence supporting routine use is limited and recommendations vary by context. Some regimens have been discouraged by guidelines when evidence is lacking or inconsistent. In all settings, careful monitoring of kidney function and urine output guides therapy, and renal replacement therapy may be required for established acute kidney injury.

Overall, nefroprotektiva emphasizes prevention through risk stratification, avoidance of nephrotoxins, and meticulous fluid and medication management, recognizing that universally effective nephroprotective drugs are not established for all scenarios.