Which drugs cause acute kidney injury?

Acute kidney injury is an abnormality of renal structure or function caused by various reasons for not more than 3 months, which is manifested by a short-term progressive decline in renal function (absolute value of blood creatinine elevation >0.3 mg/dl in at least two examinations within 48h, or urine output <180 ml/6 hours). In mild cases, the patient has no conscious symptoms and recovers quickly, while in severe cases, it is life-threatening and leads to death. Acute kidney injury is very common in the clinic and has a high prevalence rate, but the awareness rate is low. Recent studies have found that acute kidney injury can lead to chronic kidney disease and ultimately uremia. The theme of this year's World Kidney Day is prevention and treatment of acute kidney injury, hoping to raise awareness of kidney protection, prevent and treat acute kidney injury, and reduce the incidence of chronic kidney disease through publicizing the knowledge of acute kidney injury to the public. In daily life, people often take antibiotics and antipyretics after catching a cold, and the effect seems to be "cure the disease", but clinically, we often see acute kidney injury caused by taking cold medicine. Therefore, the folk have always believed that the medicine is three times poisonous, the use of drugs to be cautious is not unreasonable. This is because the kidneys are important detoxification and excretion organs of the human body, we eat into the vast majority of the kidneys to be concentrated by the kidneys after excretion, resulting in high concentrations of drugs in the kidneys locally, so the kidneys are very susceptible to drug damage. The most common nephrotoxic drugs are: aminoglycoside antibiotics (e.g. gentamicin), non-steroidal anti-inflammatory drugs (antipyretic and analgesic), antitumor drugs, diuretics, contrast media, etc.. In recent years, a few Chinese medicines have also been shown to be nephrotoxic, and they include Chinese medicines containing aristolochic acid as a component, such as Guanmutong, Tianxianteng, Guangfengji, Qingmuxiang, Ganlu Disinfecting Pill, Longdian Diarrhea Liver Pill, Pai Shi Chongzhi, Guanxin Suho Pill, and Gynecological Dividing Pill, among other proprietary Chinese medicines. The most prominent clinical manifestation of acute kidney injury is the decrease of urine volume. The average urine output of a normal person is 1500 milliliters per day, 4-8 times per day. If there is no fever, a lot of sweating, drinking a lot of water, etc., the urine volume appears to decrease abruptly, we must pay attention to it, go to the hospital in time for examination, urine examination can be seen hematuria, proteinuria and tubular urine. Acute kidney injury can also cause toxic symptoms due to the retention of toxins in the body, such as: anorexia, nausea, vomiting, edema, panic, shortness of breath, dyspnea and so on. Acute kidney injury is certainly dangerous, but timely treatment can be cured. The key is early detection and timely diagnosis and treatment. It is not difficult to detect acute kidney injury, and it can be detected early by checking the urine routine and kidney function of the susceptible people in time. Sometimes it is not easy to diagnose the cause of the disease, and it is necessary to be hospitalized for renal pathology examination. Treatment of acute kidney injury varies from person to person and from disease to disease. The general principles are: rest, supplementation, removal of the cause, protection of renal function, correction of metabolic disorders and renal replacement therapy. Due to the application of blood purification technology, the prognosis of patients with severe acute renal failure has been greatly improved. A small number of patients may turn into chronic renal failure and require long-term dialysis. Although most of the patients with acute kidney injury can completely normalize their renal function with active treatment after the cause is removed. However, recent studies have found that acute kidney injury can also cause chronic kidney disease. Some patients with acute kidney injury may have chronic kidney disease (e.g. the elderly), and it is not easy for these patients to normalize their renal function.