nefrotoksilisust

Nefrotoksilisus, or nephrotoxicity, refers to damage to the kidneys caused by exposure to toxic substances. The condition can result from drugs, chemicals, environmental toxins, or medical procedures. In clinical practice, nephrotoxicity is a major concern because it can impair renal function, lead to acute kidney injury, or worsen chronic kidney disease.

The mechanisms of kidney injury vary according to the agent involved. Many nephrotoxic drugs accumulate within proximal tubular cells, triggering oxidative stress, mitochondrial dysfunction, or direct membrane damage. Contrast agents used in imaging studies may cause tubular obstruction and ischemia. Heavy metals such as cadmium and lead interfere with transport proteins and promote fibrosis. Bacterial toxins, such as endotoxins in sepsis, can activate inflammatory cascades that damage glomerular and tubular structures.

Early signs of nephrotoxicity include reduced urine output, hematuria, or proteinuria. More advanced injury may present with electrolyte abnormalities, elevated serum creatinine, and uremic symptoms. Diagnosis relies on serum creatinine, estimated glomerular filtration rate, urinary biomarkers, and imaging when needed.

Management focuses on eliminating the offending agent, optimizing hydration, and providing supportive care. Renal replacement therapy is indicated for severe acute kidney injury. Preventive measures include dose adjustment based on renal function, use of alternative agents, and monitoring of renal biomarkers in high‑risk patients.

Nefrotoksilusust is a growing public health concern, especially with increased use of novel pharmaceuticals and imaging technologies. Ongoing research examines early biomarkers, protective strategies, and the development of less nephrotoxic drug formulations.