Nephrotoxic Mechanisms of Drugs and Environmental Toxins

The majority of the offending toxicants to be reviewed in this volume were devel­ oped to help mankind, and it is only with prolonged or widespread application that their adverse effects have been recognized. Conversely, in the case of pre scrip­ tion drugs, there has been an attempt to identify the adverse effects in advance and incorporate these risks into the decision of approval for human consumption. Unfortunately, for those drugs in which recognized injury occurs only after prolonged use, such appraisals are made in retrospect. Despite this, most renal injury induced by drugs or toxicants can be either prevented by excluding drugs with unacceptable side effects or interrupted by eliminating the offending agent once damage is manifested. The fact that prevention, reversibility, or arrest of renal injury is possible provided a major impetus for this publication. Since no international registry for nephrotoxic injury exists, estimates of incidence must rely on less than ideal sources. Recently I, together with Dr. William Bennett, summarized a survey of the frequency of various categories of nephrologic disease (Porter and Bennett, 1981). Based on this survey, we projected that in nearly one of ten patients seeking nephrologic consultation a nephrotoxic etiology may be involved. Of cases of end-stage renal disease, between 3 and 4% are due to drug nephrotoxicity, according to recent published results(European Dialysis and Transplant Association, 1979). For acute renal failure, antibiotics and contrast agents persist as major offending agents, while for chronic renal failure, analgesics remain a worldwide problem. Front Matter....Pages i-xix Front Matter....Pages 1-1 Overview of Pathophysiology of Acute Renal Failure....Pages 3-9 Pathology of Acute Renal Failure....Pages 11-23 Effect of Heavy Metals on Sodium Transport in Vitro ....Pages 25-35 Renal Hemodynamics in Nephrotoxic Acute Renal Failure....Pages 37-56 The Glomerulus in Acute Renal Failure....Pages 57-64 Heavy Metal Models of Experimental Acute Renal Failure....Pages 65-76 Studies on Segmental Transport in Models of Acute Renal Failure....Pages 77-84 Enhancement of Renal Regeneration by Amino Acid Administration....Pages 85-94 Amphotericin B Toxicity for Epithelial Cells....Pages 95-98 Front Matter....Pages 99-99 Antibiotic Nephrotoxicity....Pages 101-105 Functional Considerations in Aminoglycoside Nephrotoxicity....Pages 107-116 Aminoglycoside Nephrotoxicity....Pages 117-134 Aminoglycoside Interactions with Other Drugs....Pages 135-150 Nephrotoxicity of Cephalosporin Antibiotics....Pages 151-164 Tetracycline Nephrotoxicity....Pages 165-177 Front Matter....Pages 179-179 Tubulointerstitial Nephropathy....Pages 181-187 Current Concepts of Tubulointerstitial Nephritis....Pages 189-195 Analgesic Nephropathy....Pages 197-208 Analgesic Nephropathy....Pages 209-225 Endemic Balkan Nephropathy....Pages 227-240 Front Matter....Pages 179-179 Nephrotoxicity of Natural Products....Pages 241-254 Lead Nephrotoxicity....Pages 255-265 The Rat as an Animal Model of Lead Nephropathy....Pages 267-277 Front Matter....Pages 279-279 Environmental Toxicities and Hazards....Pages 281-283 Metabolism of Cadmium....Pages 285-303 Cadmium Nephropathy....Pages 305-313 Ultrastructural and Biochemical Localization of Organelle Damage from Nephrotoxic Agents....Pages 315-330 Mechanisms of Acute Nephrotoxicity....Pages 331-344 Potentiation of the Action of Nephrotoxic Agents by Environmental Contaminants....Pages 345-356 Alteration of Chloroform-Induced Nephrotoxicity by Exogenous Ketones....Pages 357-365 Front Matter....Pages 367-367 Drug-Induced Renal Lesions....Pages 369-371 Antihistone Antibodies Induced by Procainamide and Hydralazine....Pages 373-381 Drug- and Toxin-Induced Nephritides....Pages 383-392 Immunologic Mechanisms in Drug-Induced Acute Interstitial Nephritis....Pages 393-402 Drug-Induced Nephritides....Pages 403-408 Gold-Induced Autoimmune Reactions....Pages 409-412 Mercuric Chloride-Induced Immunologically Mediated Diseases in Experimental Animals....Pages 413-423 Genetic Control of Mercury-Induced Immune Response in the Rat....Pages 425-435 The Application of a Radioimmunoassay for Sensitive Detection of Metallothionein (Thionein) in Physiologic Fluid of Humans and Rats....Pages 437-449 Back Matter....Pages 451-466