Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) |
Ibuprofen, Naproxen, Indomethacin |
Acute kidney injury (AKI) due to reduced renal blood flow |
Use with caution in patients with pre-existing kidney disease; monitor renal function, especially in elderly or dehydrated patients. |
Aminoglycosides |
Gentamicin, Tobramycin, Amikacin |
Nephrotoxicity due to tubular cell damage, leading to acute tubular necrosis (ATN) |
Monitor drug levels and renal function; limit duration of therapy and ensure adequate hydration. |
Angiotensin-Converting Enzyme Inhibitors (ACE Inhibitors) & Angiotensin II Receptor Blockers (ARBs) |
Lisinopril, Enalapril, Losartan, Valsartan |
Can cause a decrease in glomerular filtration rate (GFR), leading to acute kidney injury |
Monitor renal function and potassium levels, especially in patients with heart failure, chronic kidney disease (CKD), or volume depletion. |
Contrast Agents |
Iodinated contrast for CT scans |
Contrast-induced nephropathy (CIN), characterized by acute kidney injury |
Use the lowest effective dose; ensure adequate hydration before and after contrast administration; consider alternatives in high-risk patients. |
Calcineurin Inhibitors |
Ciclosporin, Tacrolimus |
Chronic interstitial nephritis, leading to progressive kidney damage |
Monitor drug levels and renal function regularly; adjust dose as needed to minimize toxicity. |
Diuretics |
Furosemide, Hydrochlorothiazide |
Volume depletion leading to pre-renal azotemia; electrolyte imbalances |
Monitor electrolytes and renal function; adjust dose based on patient response and avoid over-diuresis. |
Amphotericin B |
Conventional Amphotericin B |
Nephrotoxicity due to tubular cell damage and electrolyte imbalances |
Use liposomal formulations if possible; monitor renal function and electrolytes closely; ensure adequate hydration. |
Chaemotherapeutic Agents |
Cisplatin, Methotrexate |
Acute kidney injury due to tubular toxicity; can lead to chronic kidney disease |
Monitor renal function and hydration status; use protective agents like amifostine with cisplatin; dose adjustment may be required. |