{"title":"New perspectives of drug related kidney diseases and disorders.","authors":"Sandra L Kane-Gill","doi":"10.1097/MCC.0000000000001210","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>The aim of this review is to provide a discussion of new perspectives for up-to-date definitions, a contemporary classification system, and the potential role of stress and damage biomarkers in the context of drug related kidney diseases and disorders.</p><p><strong>Recent findings: </strong>Acute kidney disease (AKD) is a term recently introduced in the literature describing an abnormality in kidney structure and function that lasts for less than 3 months. Drugs in the context of AKD is described as a new perspective; referred to as drug induced AKD. A framework that includes drugs into the 2X2 classification schema for acute kidney injury (AKI) is provided. Finally, stress and damage biomarkers are examined to assess risk of drug associated AKI (D-AKI), differentiate which drugs cause AKI, differentiate drugs from other etiologies and assess the prognosis of D-AKI.</p><p><strong>Summary: </strong>Consistent definitions should be adopted with consideration to drug related diseases and disorders. Drug management can be guided using novel biomarkers to isolate a possible drug cause in the presence of more than one nephrotoxin or a nondrug cause, assisting with the diagnosis of pseudo-AKI, and deciding the likelihood AKI recovery. Furthermore, stress and damage kidney biomarkers provide the opportunity to detect subclinical AKI for early intervention in patients at high-risk for severe AKI.</p>","PeriodicalId":10851,"journal":{"name":"Current Opinion in Critical Care","volume":null,"pages":null},"PeriodicalIF":3.5000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Opinion in Critical Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MCC.0000000000001210","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/13 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose of review: The aim of this review is to provide a discussion of new perspectives for up-to-date definitions, a contemporary classification system, and the potential role of stress and damage biomarkers in the context of drug related kidney diseases and disorders.
Recent findings: Acute kidney disease (AKD) is a term recently introduced in the literature describing an abnormality in kidney structure and function that lasts for less than 3 months. Drugs in the context of AKD is described as a new perspective; referred to as drug induced AKD. A framework that includes drugs into the 2X2 classification schema for acute kidney injury (AKI) is provided. Finally, stress and damage biomarkers are examined to assess risk of drug associated AKI (D-AKI), differentiate which drugs cause AKI, differentiate drugs from other etiologies and assess the prognosis of D-AKI.
Summary: Consistent definitions should be adopted with consideration to drug related diseases and disorders. Drug management can be guided using novel biomarkers to isolate a possible drug cause in the presence of more than one nephrotoxin or a nondrug cause, assisting with the diagnosis of pseudo-AKI, and deciding the likelihood AKI recovery. Furthermore, stress and damage kidney biomarkers provide the opportunity to detect subclinical AKI for early intervention in patients at high-risk for severe AKI.
综述的目的:本综述旨在讨论最新定义的新视角、当代分类系统以及应激和损伤生物标志物在药物相关肾脏疾病和紊乱中的潜在作用:急性肾脏病(AKD)是最近出现在文献中的一个术语,描述持续时间少于 3 个月的肾脏结构和功能异常。药物在急性肾脏病中被描述为一个新的视角;被称为药物诱发的急性肾脏病。本文提供了一个将药物纳入急性肾损伤(AKI)2X2 分类模式的框架。最后,研究了应激和损伤生物标志物,以评估药物相关性 AKI(D-AKI)的风险,区分哪些药物会导致 AKI,将药物与其他病因区分开来,并评估 D-AKI 的预后。可使用新型生物标志物指导药物管理,以在存在一种以上肾毒素或非药物原因的情况下分离出可能的药物原因,协助诊断假性 AKI,并决定 AKI 恢复的可能性。此外,应激和损伤肾脏生物标志物为检测亚临床 AKI 提供了机会,以便对严重 AKI 高危患者进行早期干预。
期刊介绍:
Current Opinion in Critical Care delivers a broad-based perspective on the most recent and most exciting developments in critical care from across the world. Published bimonthly and featuring thirteen key topics – including the respiratory system, neuroscience, trauma and infectious diseases – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.