Nephrotoxicosis

Nephrotoxicosis refers to kidney damage caused by exposure to toxic substances. These toxins can be exogenous, meaning they are introduced from outside the body, such as certain medications, chemicals, or heavy metals. Endogenous toxins, which are produced within the body, can also contribute to nephrotoxicosis, particularly in conditions like rhabdomyolysis or multiple myeloma.

The mechanism of kidney injury varies depending on the specific nephrotoxin. Some substances directly injure kidney cells, leading to cellular death and impaired function. Others can cause obstruction of the kidney tubules, reduce blood flow to the kidneys, or trigger an inflammatory response that damages kidney tissue. The severity of nephrotoxicosis can range from mild, temporary dysfunction to severe, irreversible kidney failure.

Symptoms of nephrotoxicosis are often non-specific and can include changes in urine output (either decreased or increased), swelling in the legs and feet, fatigue, nausea, and abdominal pain. In more severe cases, individuals may experience confusion, shortness of breath, and even seizures. Diagnosis typically involves blood tests to assess kidney function (creatinine and BUN levels), urine tests to detect abnormalities, and sometimes imaging studies.

Treatment focuses on removing or minimizing exposure to the offending toxin, supportive care to manage symptoms and complications, and in severe cases, dialysis to assist kidney function. Prevention is key and involves careful use of potentially nephrotoxic medications, avoiding exposure to environmental toxins, and maintaining adequate hydration.