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  • Title: [Drug-induced nephropathies].
    Author: Fillastre JP, Dhib M, Godin M, Moulin B.
    Journal: Ann Med Interne (Paris); 1989; 140(7):600-4. PubMed ID: 2610454.
    Abstract:
    The list of nephrotoxic drugs is long. The kidney is particularly susceptible to the nephrotoxic action of drugs, because of its functional properties, including: a) the high volume of renal blood flow, which brings large amounts of toxin; b) the large area in contact with the drug, either in the glomerulus or the tubule epithelium, which enables toxin interaction or uptake; c) the kidney's ability to transfer active substances, which provides specific transfer mechanisms that mediate cellular uptake; d) drug breakdown, which may occur in renal tubules and lead to the formation of toxic metabolites from non-toxic parent substances; e) the kidney's concentrating mechanisms, which can increase urinary and interstitial concentrations of non-absorbed products; f) the high metabolic rate of tubule cells required for normal function, which is subject to perturbation. Indeed, nephrotoxins affect every aspect of renal pathology, from acute renal failure due to functional alterations to that resulting from tubule cell necrosis. These anomalies may occur suddenly or after a long period of exposure to the toxic agent. They may be localized in the cortex or the medulla and affect all parts of the nephron: the glomeruli, the tubules, the interstitium or the vessels. How then is the topic of a brief expose to be chosen? It was made based upon the results of a questionnaire addressed to French nephrologists.
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