American Journal of Pediatrics
Volume 4, Issue 3, September 2018, Pages: 61-68
Received: Jun. 28, 2018;
Accepted: Aug. 19, 2018;
Published: Sep. 19, 2018
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Sergey Postnikov, Chair of Clinical Pharmacology, Pirogov Russian National Research Medical University, Moscow, Russian Federation
Anna Gratzhianskaya, Chair of Clinical Pharmacology, Pirogov Russian National Research Medical University, Moscow, Russian Federation
Marya Kostyleva, Chair of Clinical Pharmacology, Pirogov Russian National Research Medical University, Moscow, Russian Federation
Aleksey Ermilin, Chair of Clinical Pharmacology, Pirogov Russian National Research Medical University, Moscow, Russian Federation
Drugs are common cause of renal damage - approximately 20% of out-patient and in-patient cases of acute renal failure are caused by drugs. The main reasons for this situation are the following: rapid growth of pharmaceutical market and therefore increased amount of drugs with known nephrotoxicity, aging of the population that is accompanied by the accumulation of such diseases like diabetes mellitus (DM), heart failure (HF), arterial hypertension (AH) following by the obligatory polypharmacy. On the other hand the achievements of contemporary medical science contribute to survivals of significant quantity of premature neonates with low and extremely low body weight. Thus the different types of pathological conditions like bronchopulmonary dysplasia (BPD), respiratory distress syndrome (RDS), sepsis, pneumonia, necrotic enterocolitis corresponding to such category of patients require aggressive treatment with off-label use. All factors listed above contribute to drug overload in the mentioned age-groups including drugs excreted by kidneys with possible damage of different renal structures and functions. The primary preventive measures could be the following: avoidance of the combination of drugs with known nephrotoxic effect, sufficient hydration and assessment of renal functioning using current biomarkers measuring before and in the progress of the treatment with potential nephrotoxic effect. It could be recommended the decreasing dose or interruption of the suspected drug in accordance with the deviation of parameters comparing to the baseline.
Acute and Chronic Renal Diseases Associated with Different Drugs in Children, American Journal of Pediatrics.
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