Toxic nephropathies of anticholinesterase compounds.

ABSTRACT

Nephrotoxicity is not generally recognized as a major clinical feature of anticholinesterase (AntiChE) compound poisoning. While very few case reports and experimental data are available on the topic, clinical reports suggest that the nephrotoxic effects of antiChE agents may be more common than is commonly believed. The effect of antiChE agents on the human kidney has not been carefully or thoroughly evaluated. Limited experimental data indicate that acetylcholine (ACh) which accumulates in the presence of antiChE agents, as well as antiChE agents themselves, can significantly alter renal function. This may result from alterations in neural, humoral, and metabolic activity. Some experimental data also indicate that antiChE agents may have direct nephrotoxic effects on renal tubules. This article aims to highlight antiChE agents as potential nephrotoxins. Further work is needed to explore the potential nephrotoxicity of antiChE agents in humans. Patients need to be more closely and carefully evaluated for evidence of nephrotoxic injury.