avoid use in high-risk patients, use alternative imaging, use low-dose
How can we prevent Contrast Media-Induced nephropathy? (3)
high dose, once daily intermittent dosing
How can we prevent AG-induced nephrotoxicity?
>=65 years, dehydration, preexisting kidney disease, renal irradiation, concurrent use of nephrotoxic drugs, large cumulative doses, alcohol abuse
What are risk factors for Cisplatin-induced Nephrotoxicity? (6)
a thiol phosphate prodrug that gets converted by normal cells and chelates cisplatin; protecting the cells
Amifostine MOA?
amifostine, hypertonic saline, IV magnesium, intraperitoneal administration
How can we prevent Cisplatin-induced Nephrotoxicity? (4)
dose given
Amphotericin nephrotoxicity often corresponds to the _________.
interacts with ergosterol and increases the permeability of the cells-necrosis; causes afferent arteriole vasoconstriction-ischemia
How does Amphotericin cause nephrotoxicity? (2)
use lipid/liposomal formulations, smaller dose, longer infusion time, other antifungals
How can we prevent Amphotericin nephrotoxicity? (4)
mannitol, dextran, sucrose/maltose vehicles
Which drugs can cause Osmotic nephropathy? (3)
via uptake through pinocytosis into proximal tubular epithelial cells, subsequent formation of vacuoles, and accumulation of lysosomes; causing cell to swell
How do Osmotic agents cause nephropathy? (3)
constriction; dilation
Drug-induced causes of hemodynamic kidney injury typically stem from
________ of glomerular afferent arterioles or _______ of glomerular
efferent arterioles
NSAIDs, ACEi/ARB
Which drugs cause the most Pre-renal AKI? (2)
use NSAIDs with less anti-prostaglandin activity, avoid ACEi/ARB, lower dose/shorter half life
How can we prevent NSAID AKI? (3)
extensive hydration + alkalinizing urine above 7.15
How can we prevent Obstructive Nephropathy?