Drug-related acute kidney injury in children / 中华实用儿科临床杂志

ABSTRACT

Drug-related acute kidney injury(AKI)is a common problem in clinical medicine.It is more prone to occur in children,especially in children with severe infection,low circulating blood volume,congestive heart failure,diabetes and chronic kidney disease clinically.Mechanisms include altered intra-glomerular haemodynamics, oxidative damage,hypersensitivity reactions,renal obstruction,tubular inflammatory changes,interstitial nephritis,rhab-domyolysis,thrombotic microvascular disease and metabolic disorders. Therefore,the early detection of adverse drug reactions to prevent its progression to end-stage renal disease is important.Despite many efforts to improve the early assessment of AKI in patients,effective markers are still lacking.Preventive measures requires knowledge of mecha-nisms of drug-induced AKI,improve the prognosis by correcting risk factors,assessing baseline renal function before initiation of therapy,adjusting the drug dosage and avoiding use of nephrotoxic drug combinations.