Nephrotoxicity refers in general to anything that can be toxic — that is, poisonous — to the kidney. However, in this section the topic is specifically situations in which medical treatment itself can create a threat to the kidney, either through diagnostic procedures or through therapy for disorders of other organs.
Certain diagnostic procedures, such as CT scans and cardiac angiography, require that patients have substances called “radio-contrast agents” injected into their bloodstreams prior to the procedure. The contrast agents are essentially dyes that help to provide a clear picture during the diagnostic test. The contrast agents are injected into a vein. People who are at increased risk of radio-contrast agent-induced nephrotoxicity inclose those who have diabetes, kidney disease, or who are taking angiotensin-converting enzyme (ACE) inhibitors.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Acetylcysteine, Sodium Bicarbonate
Cyclosporine is used to treat a variety of autoimmune diseases, cancers, and to suppress rejection after some types of transplant surgery. However, it may damage the kidney by constricting and injuring the arteries and causing ischemia (inadequate blood flow) in the glomeruli (a part of the kidney that is responsible for the filtration of blood into urine). Medications can be given to help prevent such damage, notably those that reverse such constriction by relaxing the arteries in the kidneys.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Diltiazem, Felodipine, Isradipine, Nifedipine, Verapamil
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