Early symptoms of drug-induced renal injury?

summary

Drug induced renal damage refers to drug-induced renal disease caused by adverse drug reactions or adverse drug events. The manifestations of renal damage caused by different drugs are diverse, including hematuria, proteinuria, abnormal urine volume, renal tubular dysfunction (such as renal tubular acidosis, renal diabetes), nephritis syndrome, nephrotic syndrome, acute kidney injury, chronic renal failure, etc. Early symptoms of drug-induced renal injury? Let's talk about it.

Early symptoms of drug-induced renal injury?

1. Systemic manifestations the systemic manifestations of patients with drug-induced renal damage are related to drug allergy, drug itself and (or) multi system manifestations caused by renal failure. Drug allergy mainly manifested as fever, rash, joint pain, muscle pain, etc; The symptoms of digestive system were abdominal pain, diarrhea and anorexia; The damage of blood system was characterized by leukopenia or increase, anemia, and thrombocytopenia; Liver damage may include liver pain, jaundice and so on. In addition, there are respiratory system, nervous system, cardiovascular system and other multi system damage.

2. Manifestations of renal damage (1) acute renal failure: acute renal failure caused by drug nephrotoxicity is mostly non oliguria type, but blood creatinine and urea nitrogen increase rapidly, creatinine clearance rate decreases, urine specific gravity and urine osmotic pressure decrease, which may be accompanied by metabolic acidosis and electrolyte disorder. Most of the renal damage caused by penicillin allergy occurred within 24 hours after medication. (2) acute anaphylactic interstitial nephritis: it is caused by drug allergy. Besides systemic manifestations, there are also manifestations of kidney damage: ① renal anaphylactic reaction, manifested as aseptic leucocyturia; ② acute anaphylactic interstitial nephritis, manifested as acute anaphylactic interstitial nephritis; ② Renal tubular function damage, severe can cause acute renal failure; ③ Stopping the drug in time, using immunosuppressive agents such as methylprednisolone or desensitizing drugs can make the renal function recover and the urine test normal.

3. Acute nephritis syndrome or nephrotic syndrome: glomerulonephritis caused by immune response, clinical manifestations are proteinuria, hematuria, elevated blood pressure and edema, a few patients with high edema, hypoproteinemia and other manifestations of nephrotic syndrome.

matters needing attention

1. Discontinue the drugs that cause renal damage. For the drugs that are highly suspected of causing drug-induced renal damage, the dosage should be reduced or stopped immediately, and the renal function of patients can recover quickly. 2. Diuretic treatment, drinking a lot of water, furosemide was used to clear the crystal of obstructed renal tubules. The patients with renal failure should not drink a lot of water to avoid increasing the capacity burden. 3. Glucocorticoid can be used for acute allergic interstitial nephritis caused by penicillin antibiotics, anticancer drugs and non steroidal anti-inflammatory drugs, which can significantly improve renal function. Glucocorticoids can also be used to treat drug-induced renal damage with nephrotic syndrome or nephritis syndrome. 4. Immunosuppressant can have better effect when the effect of adrenocortical hormone is not satisfied. 5. Hemodialysis or peritoneal dialysis can be used in the treatment of acute renal failure, which is helpful to the clearance of drugs.