Drug-Induced Nephrotoxicity: A Review

Abstract
Background: Nephrotoxicity is referred to as rapid degeneration in kidney functioning due to the toxic effects of medications. The glomerulus and proximal renal tubule are the fundamental portions of the nephron to be affected by drugs leading to nephrotoxicity. Prescribed medications like antibiotics (aminoglycoside, and vancomycin), amphotericin B, antidepressants (amitriptyline, fluoxetine), acyclovir, angiotensin-converting enzyme inhibitors, Angiotensin receptor blockers, non-steroidal anti-inflammatory drugs, cocaine, statins, antihistamines (Diphenhydramine), and sulfonamides can result in specific outcomes relative to nephrotoxicity, such as renal injury, inflammation, platelet aggregation, cell cytotoxicity, thrombosis, reduced renal blood flow, and crystal precipitation result in nephrotoxicity. Objective: we aimed to review the various pathogenic mechanisms responsible for drug-induced nephrotoxicity including, altered intra-glomerular hemodynamics, tubular cell toxicity, renal inflammation, crystal nephropathy, rhabdomyolysis, and thrombotic microangiopathy. The review also highlights risk factors related to the patient and the drugs being prescribed. The majority of the nephrotoxicity risk factors depend on the patients' age, gender, pre-existing renal insufficiency, drug dosage, and hypersensitivity to drug toxicity. Methods: We have searched the different databases to recruit published material mainly focusing on Pubmed, GoogleScholars, and Iraqi Virtual Science Library. Conclusion: To sum up, the review explains the necessity of evaluating nephrotoxicity, drug dosage, and risk factors as primary preventive measures to avoid drug-induced Nephrotoxicity.