Nephrotoxic Medications and Their Risks

Nephrotoxic Medications

• The National Kidney Foundation recommends that vancomycin, especially when used in combination with other nephrotoxic agents, or in patients with pre-existing renal impairment, carries a high risk of nephrotoxicity 1
• The use of furosemide can enhance nephrotoxicity of other drugs like cisplatin, according to the American Society of Nephrology 1

Risk Factors for Drug-Induced Nephrotoxicity

• Patient-specific factors, such as pre-existing renal impairment, volume depletion, and diabetes mellitus, increase the risk of nephrotoxicity, as stated by the National Institute of Diabetes and Digestive and Kidney Diseases 1
• Medication-related factors, including concomitant use of multiple nephrotoxic agents, high doses, and prolonged duration of therapy, also increase the risk of nephrotoxicity, according to the American College of Clinical Pharmacy 1

Monitoring and Prevention

• The American Society of Health-System Pharmacists recommends monitoring serum creatinine and assessing for changes in urine output in patients on vancomycin 1
• Using the lowest effective dose and shortening the duration of therapy when possible can help minimize the risk of nephrotoxicity, as suggested by the European Renal Association 1