Nephrotoxicity of anti-infective drugs in intensive care unit: an update

Authors

  • Sofiane Salhi Département de néphrologie et de transplantation d’organes, centre de maladie rares, hôpital universitaire de Toulouse, Toulouse, France
  • Camille Saint-Jacques Service des Explorations Fonctionnelles Multidisciplinaires, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, 75020 Paris, France.
  • Cédric Rafat Soins Intensifs Néphrologiques et Rein Aigu, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Paris, France.

DOI:

https://doi.org/10.37051/mir-00153

Keywords:

anti-infective, acute kidney injury, drugs, toxicity

Abstract

In intensive care unit, drugs are responsible of 25% of acute kidney injury [1], and among them, anti-infectious are oftenly concerned. Renal tubule, at the crossroads of drug excretion after glomerular filtration, play a major role in this pathogenesis. Targeted in this decisive square, proximal convoluted tubule (PCT) can be affected directly on its apical or basolateral pole, or undirectly after hemolysis and rhabdomyolysis. Drug accumulation in the tubule’s lumen can also interrupt urinary flow, forming cristals or aggregates. Allergic reaction can occur triggering T cells activation thus interstitial infiltration leading to kidney injury. Finally, some drugs are responsible for an inhibition of the tubular secretion, without any loss of glomerular filtration.

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Published

2023-05-16

How to Cite

Salhi, S., Saint-Jacques, C., & Rafat, C. (2023). Nephrotoxicity of anti-infective drugs in intensive care unit: an update . Médecine Intensive Réanimation, 32(2), 209–222. https://doi.org/10.37051/mir-00153