Drugs and Kidney
Medicines are thrown out of the body either by the liver or the kidneys. These medicines may undergo alteration in the body called drug metabolism. The resulting products are drug metabolites. Water soluble drugs or metabolites often get excreted by kidneys.
Mechanism of drug toxicity:
As the concentration in kidneys is high, kidney tissues can be damaged by these drugs. Drugs can be absorbed by kidney cells when these are filtered. If the drug then is neither absorbed back in blood or metabolised by these cells, it can accumulate to toxic levels.
Some drugs can cause an allergy like reaction in the kidneys (antibiotics specially of cephalosporin group) and cause acute kidney injury.
Other drugs eg aminoglycosides, contrast material used in X Ray and CT Studies, anti fungal and anticancer drugs, almost always cause kidney damage if used for long periods or in heavier dosage.
The damage is more severe in already diseased kidneys.
Heavy metals are often used in alternative medical systems. Arsenic, lead, copper, gold and many others can cause various varieties of kidney damage.
This damage caused by drugs may at times be irreversible and lead to CKD requiring life long dialysis or renal transplant.
Drug induced damage can be prevented by avoiding unnecessary drugs, using drugs in correct doses and measuring kidney function regularly to stop the drug if the damage is detected.
For analgesic related kidney injury : See previous posts.