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44.
Drug dosage in renal failure
Appendix: Drug dosing in renal failure
Abbreviations used:
ACE: angiotensin-converting enzyme

AV: atrioventricular
BUN: blood urea nitrogen
CCr: Creatinine clearance
CAPD: continuous ambulatory peritoneal dialysis
CHF: congestive heart failure
CMV: cytomegalovirus
CNS: central nervous system
CRRT: continuous renal replacement therapy
CSA/FK: cyclosporine A and tacrolimus
CVD: cardiovascular disease
CVVH: Continuous venovenous hemofiltration
DVT: deep vein thrombosis
ESRD: end-stage renal disease
GI: gastrointestinal
GFR: glomerular filtration rate
HBV: hepatitis B virus
HD: hemodialysis
HDL: high-density lipoprotein
HIT: heparin-induced thrombocytopenia
HSV: herpes simplex virus
INR: international normalized ratio
IV: intravenous
MI: myocardial infarction
MMF: mycophenolate mofetil
NA: not applicable
NC: No data: no change required
NSAIDs: nonsteroidal anti-inflammatory drugs
TB: tuberculosis
TDM: therapeutic drug monitoring
VD: volume of distribution
VZV: varicella zoster virus.
919
Table 2. Antibacterial agents
920
% of drug Dosage adjustment for renal failure with GFR
Method of dosage adjustment
Drug Normal dosage excreted (ml/min): Comments
renally >50 10−50 <10 HD CAPD CVVH
Aminoglycosides
Group toxicity: all agents in this group are nephrotoxic and ototoxic; ototoxicity is worse when the patient is hyperbilirubinemic; measure serum levels for efficacy and toxicity; peritoneal
absorption increases with presence of inflammation. VD increases with edema, obesity, and ascites
Streptomycin 7.5 mg/kg q. 12 hr 60% q. 24 hr q. 24−72 hr q. 72−96 hr May be less nephrotoxic than other Half normal 20−40 mg/L/ Dose for GFR
(1.0 g q. 24 hr members of class dose after day 10−50 ml/min;
for TB) dialysis measure levels
Kanamycin 7.5 mg/kg q. 8 hr 50%−90% 60%−90% q. 30%−70% q. 20%−30% q. Avoid once-daily dosing in patients Half full 15−20 mg/L/ Dose for GFR
12 hr; 12−18 hr; 100% 24−48 hr; 100% with CCr < 30−40 ml/min or in patients dose after day 10−50 ml/min;
100% q. 12− q. 24−48 hr q. 48−72 hr with acute renal failure or an uncertain dialysis measure levels
24 hr level of kidney function
Gentamicin 1.7 mg/kg q. 8 hr 95% 60%−90% q. 30%−70% q. 20%−30% q. Concurrent penicillin treatment may Half full 3−4 mg/L/day Dose for GFR
8−12 hr; 100% 12−18 hr; 100% 24−48 hr; 100% result in subtherapeutic aminoglycoside dose after 10−50 ml/min;
q. 12−24 hr q. 24-48 hr q. 48−72 hr levels dialysis measure levels
Peak, 6−8; trough, < 2
Tobramycin 1.7 mg/kg q. 8 hr 95% 60%−90% q. 30−70% q. 20−30% q. Concurrent penicillin treatment may Half full 3−4 mg/L/day Dose for GFR
8−12 hr; 100% 12−18 hr; 100% 24−48 hr; 100% result in subtherapeutic aminoglycoside dose after 10−50 ml/min,
q. 12−24 hr q. 24-48 hr q. 48−72 hr levels dialysis measure levels
Peak, 6−8; trough, < 2
Netilmicin 2 mg/kg q. 8 hr 95% 50%−90% q. 20−60% q 12 10−20% q. May be less ototoxic than other mem- Half full 3−4 mg/L/day Dose for GFR
8−12 hr; 100% hr; 100% q 24−48 hr; 100% bers of class dose after 10−50 ml/min;
q. 12−24 hr 24−48 hr q 48−72 hr Peak, 6−8; trough, < 2 dialysis measure levels
Amikacin 7.5 mg/kg q. 12 hr 95% 60%−90% q. 30−70% q. 20−30% q. Monitor levels Half full 15−20 mg/L/ Dose for GFR
OLYAEI & BENNETT
12 hr: 100% q. 12−18 hr; 100% 24−48 hr; 100% Peak, 20−30; trough, <5 dose after day 10−50 ml/min;
12−24 hr q. 24−48 hr q. 48−72 hr dialysis measure levels
Cephalosporins (oral)
Group toxicity: Adverse effects: coagulation abnormalities, transitory elevation of BUN, rash, and serum sicknesslike syndrome
Cefaclor 250−500 mg 70% 100% 100% 50% Group toxicity 250 mg after 250 mg q. 8− No data
q. 8 hr dialysis 12 hr
Cefadroxil 500 mg to 1 g q. 80% 100% 100% 50% Group toxicity 0.5−1.0 g 0.5 g/day No data
12 hr after dialysis
Cefixime 200−400 mg q. 85% 100% 100% 50% Group toxicity 300 mg after 200 mg/day Not recom-
12 hr dialysis mended
Cefpodoxime 200 mg q. 12 hr 30% 100% 100% 100% Group toxicity 200 mg after Dose for No data
dialysis GFR<10 ml/min
Ceftibuten 400 mg q. 24 hr 70% 100% 100% 50% Group toxicity 300 mg after No data: Dose Dose for GFR
dialysis for GFR <10 10−50 ml/min
ml/min
Cefuroxime 250−500 mg 90% 100% 100% 100% Malabsorbed in presence of H2 blockers; Dose after Dose for No data
axetil q. 8 hr absorbed better with food dialysis GFR<10 ml/min
Cephalexin 250−500 mg 95% 100% 100% 100% Rare allergic interstitial nephritis; ab- Dose after Dose for No data
q. 8 hr sorbed well when given intraperitone- dialysis GFR<10 ml/min
ally; may cause bleeding from impaired
prothrombin biosynthesis
Cephradine 250−500 mg 100% 100% 100% 50% Rare allergic interstitial nephritis; ab- Dose after Dose for No darta
q. 8 hr sorbed well when given intraperitone- dialysis GFR<10 ml/min
ally; may cause bleeding from impaired
prothrombin biosynthesis
Cephalosporins (IV)
Group toxicity: may cause coagulation abnormalities, transitory elevation of BUN, rash, and serum sicknesslike syndrome
Cefamandole 1−2 g IV q. 6−8 hr 100% q. 6 hr q. 8 hr q. 12 hr Group toxicity 0.5−1.0 g 0.5−1.0 g q. Dose for GFR
after dialysis 12 hr 10−50 ml/min
Cefazolin 1−2 g IV q. 8 hr 80% q. 8 hr q. 12 hr q. 12−24 hr Group toxicity 0.5−1.0 g 0.5 g q. 12 hr Dose for GFR
after dialysis 10−50 ml/min
Cefepime 1−2 g IV q. 8 hr 85% q. 8−12 hr q. 12 hr q. 24 hr Group toxicity 1 g after Dose for GFR < Not recom-
dialysis 10 ml/min mended
Cefmetazole 1−2 g IV q. 8 hr 85% q. 8 hr q. 12 hr q. 24 hr Group toxicity Dose after Dose for GFR Dose for GFR
dialysis <10 ml/min 10−50 ml/min
Cefoperazone 1−2 g IV q. 12 hr 20% No renal adjustment required. Displaced from protein by bilirubin; may 1 g after NC NC
prolong prothrombin time; reduce dose dialysis
by 50% in patients with jaundice
Cefotaxime 1−2 g IV q. 6−8 hr 60% q. 8 hr q. 12 hr q. 12−24 hr Group toxicity 1 g after 1 g/day 1 g q. 12 hr
dialysis
Cefotetan 1−2 g IV q. 12 hr 75% q. 12 hr q. 12−24 hr q. 24 hr Group toxicity 1 g after 1 g/day 750 mg q. 12 hr
dialysis
Cefoxitin 1−2 g IV q. 6 hr 80% q. 6 hr q. 8−12 hr q. 12 hr May produce false increase in serum 1 g after 1 g/day Dose for GFR
creatinine level by interference with dialysis 10−50 ml/min
assay
Ceftazidime 1−2 g IV q. 8 hr 70% q. 8 hr q. 12 hr q. 24 hr Group toxicity 1 g after 0.5 g/day Dose for GFR
dialysis 10−50 ml/min
Ceftriaxone 1−2 g IV q. 24 hr 50% No renal adjust- Dose after di- 750 mg q. 12 hr Dose for
44. Drug dosage in renal failure
ment required alysis GFR 10−50

ml/min
Cefuroxime 0.75−1.5 g IV q. 90% q. 8 hr q. 8−12 hr q. 12−24 hr Absorbed well when given intraperito- Dose after Dose for GFR 1.0 g q. 12 hr
sodium 8 hr neally; may cause rare allergic interstitial dialysis <10
nephritis; may cause bleeding from
impaired prothrombin biosynthesis
Clindamycin 150−450 mg q. 10% No renal adjustment required Increase CSA/FK level NC NC NC
8 hr
Imipenem- 250−500 mg IV 50% 500 mg q. 8 hr 250−500 q. 250 mg q. 12 hr Causes seizures in ESRD; nonrenal clear- Dose after Dose for GFR Dose for GFR
cilastatin q. 6 hr 8−12 hr ance in acute renal failure is less than dialysis <10 ml/min 10−5 ml/min
in chronic renal failure; administer with
cilastin to prevent nephrotoxicity of
renal metabolite
Macrolides
Azithromycin 250−500 mg q. 6% No renal adjustment required No drug-drug interaction with CSA/KF NC NC NC
24 hr
Clarithromycin 500 mg q. 12 hr 20% No renal adjustment required NC NC NC
Dirithromycin 500 mg q. 24 hr No renal adjustment required Nonenzymatically hydrolyzed to active NC NC Dose for GFR
compound erythromycylamine. 10−50 ml/min
921
922
Erythromycin 250−500 mg q. 15% No renal adjustment required Increase CSA/FK levels; avoid in NC NC NC
8 hr transplant patients
Meropenem 1 g IV q. 8 hr 65% 1 g q. 8 hr 0.5−1g q. 12 hr 0.5−1 g q. 24 hr Dose after Dose for Dose for GFR
dialysis GFR<10 ml/ 10−50 ml/min
min
Metronidazole 500 mg IV q. 6 hr 20% No renal adjustment required Peripheral neuropathy; disulfiram reac- Dose after Dose for Dose for GFR
tion with alcoholic beverages; increase dialysis GFR<10 ml/min 10−50 ml/min
frequency of liver function tests (1%)
Penicillins Group toxicity: may cause bleeding
(oral) abnormalities, hypersensitivity, seizures
Amoxicillin 500 mg q. 8 hr 60% 100% 100% 50%−75% Group toxicity Dose after 250 mg q. 12 hr No data
dialysis
Ampicillin 500 mg q. 6 hr 60% 100% 100% 50%−75% Group toxicity Dose after 250 mg q. 12 hr Dose for GFR
Dicloxacillin 250−500 mg q. 50% 100% 100% 50%−75% Group toxicity NC NC No data
6 hr
Penicillin V 250−500 mg q. 70% 100% 100% 50%−75% Group toxicity Dose after Dose for No data
6 hr dialysis GFR<10 ml/min
Penicillins (IV)
Ampicillin 1−2 g IV q. 6 hr 60% q. 6 hr q. 8 hr q. 12 hr Dose after 250 mg q. 12 hr Dose for GFR
Nafcillin 1−2 g IV q. 4 hr 35% No renal adjustment is required None None Dose for GFR
10−50 ml/min
Penicillin G 2−3 million Units 70% q. 4−6 hr q. 6 hr q. 8 hr Adverse effects: seizures, false positive Dose after Dose for Dose for GFR
OLYAEI & BENNETT
IV q. 4 hr urine protein reactions; 6 million units/ dialysis GFR<10 ml/min 10−50 ml/min
day upper limit dose in ESRD
Piperacillin 3−4 g IV q. 4−6 hr No renal adjustment is required High sodium, content 1.9 mEq/g Dose after Dose for GFR Dose for GFR
dialysis <10 ml/min 10−50 ml/min
Ticarcillin/cla- 3.1 g IV q. 4−6 hr 85% 1−2 g q. 4 hr 1−2 g q. 8 hr 1−2 g q. 12 hr Specific toxicity: sodium, 5.2 mEq/g 3.0 g after Dose for GFR Dose for GFR
vulanate dialysis <10 ml/min 10−50 ml/min
Piperacillin/ 3.375 g IV q. 6−8 75%−90% q. 4−6 hr q. 6−8 hr q. 8 hr Specific toxicity: sodium, 1.9 mEq/g Dose after Dose for GFR Dose for GFR
tazobactam hr dialysis <10 ml/min 10−50 ml/min
Pentamidine 4 mg/kg/day 5% q. 24 hr q. 24 hr q. 48 hr Inhalation may cause bronchospasm; IV NC NC NC
administration may cause hypotension,
hypoglycemia, and nephrotoxicity
Quinolones
Group toxicity: agents in this group are malabsorbed in the presence of magnesium, calcium, aluminum, and iron; photosensitivity, food, dairy products, tube feeding, may also impair
absorption; theophylline metabolism is impaired; higher oral doses may be needed to treat CAPD peritonitis
Cinoxacin 500 mg q. 12 hr 55% 100% 50% Avoid Group toxicity Avoid Avoid Avoid
Fleroxacin 400 mg q.12 hr 70% 100% 50%−75% 50% Group toxicity Dose for 400 mg/day NA
GFR<10
ml/min
Ciprofloxacin 200−400 mg IV q. 60% q. 12 hr q. 12−24 hr q. 24 hr Poorly absorbed with antacids, sucral- 250 mg q. 12 250 mg q. 8 hr 200 mg IV q.
24 hr fate, and phosphate binders; decreases hr (200 mg (200 mg if IV) 12 hr
phenytoin levels; IV dose is one third of if IV)
oral dose
Lomefloxacin 400 mg q. 24 hr 76% 100% 200−400 mg q. 50% Group toxicity Dose for Dose for No data
48 hr GFR<10 GFR<10 ml/min
ml/min
Levofloxacin 500 mg q. 24 hr 70% q. 12hr 250 q. 12 hr 250 q. 12 hr L-isomer of ofloxacin: appears to have Dose for Dose for Dose for GFR
similar pharmacokinetics and toxicities GFR<10 GFR<10 ml/min 10−50 ml/min
ml/min
Moxifloxacin 400 mg q. 24 hr 20% No renal adjustment is required Group toxicity No data No data No data
Nalidixic acid 1.0 g q. 6 hr High 100% Avoid Avoid Group toxicity Avoid Avoid No data
Norfloxacin 400 mg q. 12 hr 30% q. 12 hr q. 12−24 hr q. 24 hr Group toxicity Dose for GFR Dose for No data
<10 ml/min GFR<10 ml/min
Ofloxacin 200−400 mg q. 70% q. 12 hr q. 12−24 hr q. 24 hr Group toxicity 100−200 mg Dose for 300 mg/day
12 hr after dialysis GFR<10 ml/min
Pefloxacin 400 mg q. 24 hr 11% 100% 100% 100% Excellent bidirectional transperitoneal NC NC Dose for GFR
movement 10−50 ml/min
Sparfloxacin 400 mg q. 24 hr 10% 100% 50%−75% 50% q. 48 hr Group toxicity No data: No data Dose for GFR
dose for GFR 10−50 ml/min
<10 ml/min
Trovafloxacin 200−300 mg q. 10% No renal adjustment is required Group toxicity No data No data No data
12 hr
Pentamidine 4 mg/kg/day 5% q. 24 hr q. 24 hr q. 48 hr Inhalation may cause bronchospasm; IV NC NC NC
administration may cause hypotension,
hypoglycemia, and nephrotoxicity
Rifampin 300−600 mg 20% No renal adjustment is required. Many drug interactions; decrease CSA/ NC Dose for Dose for GFR
FK level GFR<10 ml/min <10 ml/min

Trimethoprim- 800/160 mg 70% q. 12 hr q. 18 hr q. 24 hr May cause hyperkalemia; increase se- Dose after q. 24 hr q. 18 hr
sulfamethoxa- q. 12 hr rum creatinine level dialysis
zole
Vancomycin 125−250 mg 0% 100% 100% 100% Oral vancomycin is indicated only for 100% 100% 100%
(oral) q. 8 hr the treatment of Clostridium difficile
infections
Vancomycin 1 g IV q. 12 hr 90% q. 12 hr q. 24−36 hr q. 48−72 hr Nephrotoxic, ototoxic; may prolong 500 mg q. 1.0 g q. 24−96 500 mg q. 12 hr
(IV) the neuromuscular blockade effect of 12−24 hr hr
muscle relaxants
Peak, 30; trough, 5−10
Antifungal Agents
Amphoteri- 0.5−1.5 mg/kg/ <1% No renal adjustment required Nephrotoxic; may cause infusion-related q. 24 hr q. 24 hr q. 24−36 hr
cin B day reactions; give 250 ml normal saline
before each dose
Amphotec 4−6 mg/kg/day <1% No renal adjustment required
Abelcet 5 mg/kg/day <1% No renal adjustment required
AmBisome 3−5 mg/kg/day <1% No renal adjustment required
923
924
Fluconazole 200−800 mg IV q. 70% 100% 100% 50% Increase CSA/FK level 200 mg after Dose for GFR Dose for GFR
24 hr dialysis <10 ml/min 10−50 ml/min
Flucytosine 37.5 mg/kg 90% q. 12 hr q. 16 hr q. 24 hr Hepatic dysfunction; marrow suppres- Dose after 0.5−1.0 g/day Dose for GFR
sion more common in azotemic pa- dialysis 10−50 ml/min
tients: increase CSA/FK level
Griseofulvin 125−250 mg q. 1% 100% 100% 100% Increase CSA/FK level NC NC NC
6 hr
Itraconazole 200 mg q. 12 hr 35% 100% 100% 50% Poor oral absorption; increase CSA/FK 100 mg q. 100 mg q. 12− 100 mg q. 12−
level 12−24 hr 24 hr 24 hr
Ketoconazole 200−400 mg 15% 100% 100% 100% Hepatotoxic; increase CSA/FK level NC NC NC
q. 24 hr
Miconazole 1,200−3,600 1% 100% 100% 100% Increase CSA/FK level NC NC NC
mg/day
Terbinafine 250 mg q. 24 hr >1% 100% 100% 100% May cause CHF NC NC NC
Antiviral Agents
Acyclovir 200−800 mg 50% 100% 100% 50% Poor absorption; neurotoxicity in ESRD; Dose after Dose for 3.5 mg/kg/day
5x/day IV preparation can cause renal failure if dialysis GFR<10 ml/min
injected rapidly
Amantadine 100−200 mg q. 90% 100% 50% 25% NC NC Dose for GFR
12 hr 10−50 ml/min
Cidofovir 5 mg/kg weekly 90% 100% No data: avoid No data: avoid Dose-limiting nephrotoxicity with pro- No data: No data: avoid No data avoid
× 2 (induction); 5 teinuria, glycosuria, renal insufficiency; avoid
mg/kg every 2 wk nephrotoxicity and renal clearance
reduced with coadministration of pro-
benecid
OLYAEI & BENNETT
Delavirdine 400 mg q. 8 hr 5% No data: 100% No data: 100% No data: 100% NC No data No data: dose
for GFR 10−50
ml/min
Didanosine 200 mg q. 12 hr 40%−69% q. 12 hr q. 24 hr 50% q. 24 hr Adverse effects: pancreatitis Dose after Dose for Dose for GFR <
(125 mg if < 60 dialysis GFR<10 10 ml/min
kg)
Famciclovir 250−500 mg p.o., 60% q. 8 hr q. 12 hr q. 24 hr For VZV: 500 mg p.o., q. 8 hr; for HSV: Dose after No data No data: dose
q. 8−12 hr 250 p.o. , q. 12 hr; metabolized to active dialysis for GFR 10−50
compound penciclovir ml/min
Foscarnet 40−80 mg IV q. 85% 40−20 mg q. 8−24 hr, according to CCr Nephrotoxic, neurotoxic; adverse effects Dose after Dose for Dose for GFR
8 hr are hypocalcemia, hypophosphatemia, dialysis GFR<10 ml/min 10−50 ml/min
hypomagnesemia, and hypokalemia
Ganciclovir 1,000 mg q. 8 hr 95% 1,000 mg 1,000 mg q. 1,000 mg q. Oral ganciclovir should be used only for No data: No data: dose No data
(oral) q. 8 hr 8 hr 24 hr prevention of CMV infection; always use dose after for GFR <10
IV ganciclovir for the treatment of CMV dialysis ml/min
infection
Ganciclovir 1,000 mg q. 8 hr 95% 1,000 mg 1,000 mg q. 1,000 mg q. Oral ganciclovir should be used only for No data: No data: dose No data
(oral) q. 8 hr 8 hr 24 hr prevention of CMV infection; always use dose after for GFR <10
IV ganciclovir for the treatment of CMV dialysis ml/min
infection
Ganciclovir (IV) 5 mg/kg q. 12 hr 95% q. 12 hr q. 24 hr 2,5 mg/kg/day Adverse effects: granulocytopenia and Dose after
Dose for GFR 2.5 mg/kg/day
thrombocytopenia dialysis
<10 ml/min
Indinavir 800 mg q. 8 hr 10% No data: 100% No data: 100% No data: 100% Adverse effects: nephrolithiasis and NC No data: dose No data
acute renal failure due to crystalluria or for GFR <10
tubulointerstitial nephritis ml/min
Lamivudine 150 mg b.i.d. 80% q. 12 hr q. 24 hr 50 mg q. 24 hr For HBV infection Dose after No data: dose Dose for GFR
dialysis for GFR <10 10−50 ml/min
ml/min
Nelfinavir 750 mg q. 8 hr No data No data No data No data No data No data No data
Nevirapine 200 mg q. 24 hr <3 No data: 100% No data: 100% No data: 100% May be partially cleared by hemodialysis Dose after No data: dose No data: dose
for 14 days and peritoneal dialysis dialysis for GFR < 10 for GFR 10−50
ml/min ml/min
Ribavirin 500−600 mg q. 30% 100% 100% 50% Adverse effects: hemolytic uremic syn- Dose after Dose for Dose for GFR
12 hr drome dialysis GFR<10 ml/min 10−50 ml/min
Rifabutin 300 mg q. 24 hr 5−10% 100% 100% 100% NC NC No data: dose
for GFR 10−50
ml/min
Rimantadine 100 mg q. 12 hr 25% 100% 100% 50%
Ritonavir 600 mg q. 12 hr 3.50% No data: 100% No data: 100% No data: 100% Associated with many adverse drug NC No data: dose No data: dose
interactions for GFR < 10 for GFR 10−50
ml/min ml/min
Zalcitabine 0.75 mg q. 8 hr 75% 100% q. 12 hr q. 24 hr No data: No data No data: dose
dose after for GFR 10−50
dialysis ml/min
Zidovudine 200 mg q. 8 hr or 8%−25% 100% 100% 100 mg q. 8 hr Enormous interpatient variation; me- Dose for GFR Dose for GFR 100 mg q. 8 hr
300 mg q. 12 hr tabolite renally excreted <10 ml/min <10 ml/min
925
Table 3. Analgesic agents
926
Route Dosage adjustment for renal
Drug Normal dosage of drug failure with GFR (ml/min): Comments
clearance >50 10-50 <10 HD CAPD CVVH
Narcotics and narcotic antagonists
Alfentanil Anesthetic induc- Hepatic 100% 100% 100% Titrate the dose regimen No data No data No data
tion
8-40 g/kg
Butorphanol 2 mg q. 3-4 hr Hepatic 100% 75% 50% No data No data No data
Codeine 30-60 mg q. 4-6 hr Hepatic 100% 75% 50% No data No data Dose for GFR
10-50 ml/min
Fentanyl Anesthetic induc- Hepatic 100% 75% 50% No data No data No data
tion (individual-
ized)
Meperidine 50-100 mg q. 3- Hepatic 100% avoid avoid Normeperidine, an active metabolite, accumulates Avoid Avoid Avoid
4 hr in ESRD and may cause seizures; protein binding
is reduced in ESRD; 20%-25% of meperidine is ex-
creted unchanged in acidic urine
Methadone 2.5-5 mg q. 6-8 hr Hepatic 100% 100% 50%-75% NC NC No data
Morphine 20-25 mg q. 4 hr Hepatic 100% 75% avoid Increased sensitivity to drug effect in ESRD NC No data Dose for GFR
10-50 ml/min
Naloxone 2 mg IV Hepatic 100% 100% 100% No data No data Dose for GFR
10-50 ml/min
Pentazocine 50 mg q. 4 hr Hepatic 100% 75% 75% NC No data Dose for GFR
10-50 ml/min
Propoxyphene 65 mg q. 6-8 hr Hepatic 100% 100% Avoid Active metabolite norpropoxyphene accumulates Avoid Avoid No data
OLYAEI & BENNETT
in ESRD
Sufentanil Anesthetic induc- Hepatic 100% 100% 100% No data No data No data
tion
Nonnarcotics
Acetaminophen 650 mg q. 4 hr Hepatic q. 4 hr q. 6 hr q. 8 hr Overdose may be nephrotoxic; major metabolite of NC NC Dose for GFR
phenacetin. 10-50 ml/min
Acetylsalicylic acid 650 mg q. 4 hr Hepatic q. 4 hr q. 4-6 hr Avoid Nephrotoxic in high doses; may decrease GFR when Dose after None Dose for GFR
(renal) renal blood flow is prostaglandin dependent; may dialysis 10-50 ml/min
add to uremic GI and hematologic symptoms; pro-
tein binding reduced in ESRD
Table 4. Antihypertensive and cardiovascular agents
Percentage of Dosage adjustment for renal
Normal dosage Method of dosage adjustment
Drug drug excreted failure with GFR (ml/min): Comments
Starting dose Maximum dose renally >50 10−50 <10 HD CAPD CVVH
Adrenergic agonist agents
Clonidine 0.1 mg b.i.d. or 1.2 mg/day 45% 100% 100% 100% Adverse effects: sexual dysfunction, dizziness, portal NC NC Dose for
t.i.d. hypotension GFR 10−50
ml/min
Dobutamine 2.5 mcg/kg/min 15 mcg/kg/min 10% 100% 100% 100% No data No data Dose for
GFR 10−50
ml/min
Angiotensin-converting enzyme (ACE) inhibitors
Group toxicity: hyperkalemia, acute renal failure, angioedema, rash, cough, anemia, and liver toxicity
Benazepril 10 mg/day 80 mg/day 20% 100% 75% 25%−50% Group toxicity NC NC Dose for
GFR 10−50
ml/min
Captopril 6.25−25 mg 100 mg t.i.d. 35% 100% 75% 50% Adverse effects: rare proteinuria, nephrotic syn- 25%−30% NC Dose for
t.i.d. drome, dysgeusia, granulocytopenia; increases GFR 10−50
serum digoxin levels ml/min
Enalapril 5 mg/day 20 mg b.i.d. 45% 100% 75% 50% Enalaprilat is the active moiety formed in liver 20%−25% NC Dose for
GFR 10−50
ml/min
Fosinopril 10 mg/day 40 mg b.i.d. 20% 100% 100% 75% Less likely than other ACE inhibitors to accumulate NC NC Dose for
in renal failure; fosinoprilat is the active moiety GFR 10−50
formed in liver ml/min
Lisinopril 2.5 mg/day 20 mg b.i.d. 80% 100% 50%− 25%−50% Lysine analogue of a pharmacologically active enala- 20% NC Dose for
75% pril metabolite GFR 10−50
ml/min
Pentopril 125 mg q. 24 hr 80%−90% 100% 50%− 50% Group toxicity No data No data Dose for
75% GFR 10−50

ml/min
Perindopril 2 mg q. 24 hr < 10% 100% 75% 50% Active metabolite is perindoprilat; clearance of 25%−50% No data Dose for
perindopril and its metabolites is almost exclusively GFR 10−50
renal; approximately 60% of circulating perindopril ml/min
is bound to plasma proteins, whereas 10% to 20% of
perindoprilat is bound
Quinapril 10 mg/day 20 mg/day 30% 100% 75%− 75% Active metabolite is quinaprilat; 96 % of quinaprilat 25% NC Dose for
100% is excreted renally GFR 10−50
ml/min
Ramipril 2.5 mg/day 10 b.i.d. 15% 100% 50%− 25-50% Active metabolite is ramiprilat; data pertain to 20% NC Dose for
75% ramiprilat GFR 10−50
ml/min
Trandolapril 1−2 mg/day 4 mg/day 33% 100% 50%− 50% Group toxicity NC NC Dose for
100% GFR 10−50
ml/min
927
928
Angiotensin-II-receptors antagonists (ARA)
Group toxicity: hyperkalemia, angioedema (less common than ACE-inhibitors)
Candesartan 16 mg/day 32 mg/day 33% 100% 100% 50% Candesartan cilexetil is rapidly and completely bio- NC NC NC
activated by ester hydrolysis during absorption from
the GI tract to candesartan
Eprosartan 600 mg/day 400−800 mg/day 25% 100% 100% 100% Eprosartan pharmacokinetics more variable in ESRD; NC NC NC
decreased protein binding in uremia
Irbesartan 150 mg/day 300 mg/day 20% 100% 100% 100% Group toxicity NC NC NC
Losartan 50 mg/day 100 mg/day 13% 100% 100% 100% Group toxicity No data No data Dose for
GFR 10−50
ml/min
Valsartan 80 mg/day 160 mg b.i.d. 7% 100% 100% 100% Group toxicity NC NC NC
Telmisartan 20−80 mg/day <5% 100% 100% 100% Group toxicity NC NC NC
Beta blockers
Group toxicity: agents can decrease HDL level and mask symptoms of hypoglycemia; can cause bronchospasm, fatigue, insomnia, depression, and sexual dysfunction
Acebutolol 400 mg q..24 hr 600 mg q. 24 hr 55% 100% 50% 30%−50% Active metabolites with long half-lives NC NC Dose for
or b.i.d. or b.i.d. GFR 10−50
ml/min
Atenolol 25 mg/day 100 mg/day 90% 100% 75% 50% Accumulates in ESRD 25−50 mg NC Dose for
GFR 10−50
ml/min
Betaxolol 20 mg q. 24 hr 80−90% 100% 100% 50% 50% Group toxicity NC Dose for Dose for
GFR 10− GFR 10−50
50 ml/min ml/min
Bopindolol 1 mg q. 24 hr 4 mg q. 24 hr < 10% 100% 100% 100% Group toxicity NC NC Dose for
OLYAEI & BENNETT
GFR 10−50
ml/min
Carteolol 0.5 mg q. 24 hr 10 mg q. 24 hr < 50% 100% 50% 25% Group toxicity No data No Dose for
date: no GFR 10−50
change ml/min
required
Carvedilol 3.125 mg t.i.d. 25 mg t.i.d. 2% 100% 100% 100% Kinetics are dose dependent; plasma concentrations NC NC Dose for
are reported to be increased in patients with renal GFR 10−50
impairment ml/min
Celiprolol 200 mg q. 24 hr 10% 100% 100% 75% Group toxicity No data NC Dose for
GFR 10−50
ml/min
Dilevalol 200 mg b.i.d. 400 mg b.i.d. < 5% 100% 100% 100% Group toxicity NC NC No data
Esmolol (IV 50 mcg/kg/min 300 mcg/kg/min 10% 100% 100% 100% Active metabolite retained in renal failure NC NC No data
only)
Labetalol 50 mg p.o., b.i.d. 400 mg b.i.d. 5% 100% 100% 100% For IV use: 20 mg slow injection over a 2-min period; NC NC Dose for
additional injections of 40 mg or 80 mg can be given GFR 10−50
at 10-min intervals until a total of 300 mg is admin- ml/min
istered; alternatively, dose may be administered by
continuous infusion of 2 mg/min
Metoprolol 50 mg b.i.d. 100 mg b.i.d. < 5% 100% 100% See group toxicity NC NC NC
Nadolol 80 mg/day 160 mg b.i.d. 90% 100% 50% 25% Start with prolonged interval and titrate 40 mg NC Dose for
GFR 10−50
ml/min
Penbutolol 10 mg q. 24 hr 40 mg q 24 hr < 10 100% 100% 100% NC NC Dose for
GFR 10−50
ml/min
Pindolol 10 mg b.i.d. 40 mg b.i.d. 40% 100% 100% 100% NC NC Dose for
GFR 10−50
ml/min
Propranolol 40−160 mg t.i.d. 320 mg/day <5% 100% 100% 100% In ESRD: bioavailability of propranolol may increase; NC NC Dose for
metabolites may cause increased bilirubin by assay GFR 10−50
interference; hypoglycemiamay occur ml/min
Sotalol 80 bid 160 mg b.i.d. 70% 100% 50% 25%−50% Extreme caution should be exercised in the use of 80 mg NC Dose for
sotalol in patients with renal failure undergoing GFR 10−50
hemodialysis; to minimize the risk of induced ar- ml/min
rhythmia, patients initiated or reinitiated on BETA-
PACE should be placed for a minimum of 3 days (on
their maintenance dose) in a facility that can provide
cardiac resuscitation and continuous electrocardio-
graphic monitoring
Timolol 10 mg b.i.d. 20 mg b.i.d. 15% 100% 100% 100% NC NC Dose for
GFR 10−50
ml/min
Calcium channel blockers
Group toxicity: dihydropyridines can cause headache, ankle edema, gingival hyperplasia and flushing; nondihydropyridine can cause bradycardia, constipation, gingival hyperplasia, and AV
block
Amlodipine 2.5/day 10 mg/day 10% 100% 100% 100% May increase digoxin and cyclosporine levels NC NC Dose for
GFR 10−50
ml/min
Bepridil No data < 1% No data No data No data Weak vaso- Group toxicity NC No data No data
dilator and
anti-hyper-
tensive
Diltiazem 30 mg t.i.d. 90 mg t.i.d. 10% 100% 100% 100% Acute renal dysfunction; may exacerbate hyperkale- NC NC Dose for
mia; may increase digoxin and cyclosporine levels GFR 10−50
ml/min
Felodipine 5 mg b.i.d. 20 mg/day 1% 100% 100% 100% May increase digoxin levels NC NC Dose for
GFR10−50
ml/min
Isradipine 5 mg b.i.d. 10 mg b.i.d. <5% 100% 100% 100% May increase digoxin levels NC NC Dose for
GFR 10−50
ml/min
Nicardipine 20 mg t.i.d. 30 mg t.i.d. <1% 100% 100% 100% NC NC NC
Nifedipine 30 mg/day 90 mg b.i.d. 10% 100% 100% 100% Avoid short-acting nifedipine formulation NC NC NC
XL
929
930
Nimodipine 30 mg q. 8 hr 10% 100% 100% 100% May lower blood pressure NC NC Dose for
GFR 10−50
ml/min
Nisoldipine 20 mg/day 30 mg b.i.d. 10% 100% 100% 100% May increase digoxin levels NC NC Dose for
GFR 10−50
ml/min
Verapamil 40 mg t.i.d. 240 mg/day 10% 100% 100% 100% Acute renal dysfunction; active metabolites accumu- NC NC Dose for
late particularly with sustained-release forms. GFR 10−50
ml/min
Digoxin 0.125 mg q.o.d./ 0.25 mg/day 25% 100% 100% 100% In ESRD: VD and total body clearance decreased; de- NC NC Dose for
q.d. (daily or crease loading dose by 50%; serum level 12 hr after GFR 10−50
every other day) dose is best guide to clearance; use digoxin-immune ml/min
antibodies to treat severe toxicity
Radioimmunoassay may overestimate serum levels
in uremia; clearance decreased by amiodarone, spi-
ronolactone, quinidine, and verapamil; hypokalemia
and hypomagnesemia enhance toxicity
Diuretics
Group toxicity: agents may cause hypokalemia, hyperkalemia, hyperuricemia, hyperglycemia, and hypomagnesemia; may increase serum cholesterol; use of potassium-sparing agents is
recommended
Acetazol- 125 mg t.i.d. 500 mg t.i.d. 90% 100% 50% Avoid May potentiate acidosis; ineffective as diuretic in No data No data Avoid
amide ESRD; may cause neurologic side effects in dialysis
patients
Amiloride 5 mg/day 10 mg/day 50% 100% 100% Avoid Hyperkalemia with GFR < 30 ml/min, especially in No data No data No data
diabetics; may cause hyperchloremic metabolic
OLYAEI & BENNETT
acidosis
Bumetanide 1−2 mg/day 2-4 mg/day 35% 100% 100% 100% Ototoxicity increased in ESRD in combination with NC NC No data
aminoglycosides; may cause muscle pain, gyneco-
mastia; high doses effective in ESRD
Chlorthali- 25 mg q. 24 hr 50% q. 24 hr q. 24 hr Avoid Ineffective Group toxicity No data No data No data
done with low
GFR
Ethacrynic 50 mg/day 100 mg b.i.d. 20% 100% 100% 100% Ototoxicity increased in ESRD in combination with NC NC No data
acid aminoglycosides
Furosemide 40−80 mg/day 120 mg t.i.d. 70% 100% 100% 100% Ototoxicity increased in ESRD, especially in combi- NC NC No data
nation with aminoglycosides; high doses effective
in ESRD
Indapamide 2.5 mg q. 24 hr < 5% 100% 100% Avoid Ineffective Group toxicity NC No data NC
in ESRD
Metolazone 2.5 mg/day 10 mg b.i.d. 70% 100% 100% Adverse effects: gynecomastia and impotence; high NC NC No data: no
doses effective in ESRD change re-
qurired
Piretanide 6 mg q. 24 hr 12 mg q. 24 hr 40-60% 100% 100% 100% Ototoxicity; high doses effective in ESRD NC NC No data
Spironolac- 100 mg/day 300 mg/day 25% 100% 100% Avoid Active metabolites with long half-life; hyperkalemia No data No data Avoid
tone common when GFR < 30 ml/min, especially in dia-
betics; may cause gynecomastia and hyperchloremic
acidosis; increases serum by immunoassay interfer-
ence
Thiazides 25 mg b.i.d. 50 mg b.i.d. > 95% 100% 100% Usually ineffective with GFR < 30 ml/min; effective at Avoid No data No data
low GFR in combination with loop diuretic; hyperuri-
cemia may occur
Torasemide 5 mg b.i.d. 20 mg/day 25% 100% 100% 100% Ototoxicity; high doses effective in ESRD NC NC No data; no
change re-
qiured
Triamterene 25 mg b.i.d. 50 mg b.i.d. 5%−10% q. 12 hr q. 12 hr Avoid Active metabolite with long half-life in ESRD; hyper- Avoid Avoid Avoid
kalemia common when GFR < 30 ml/min, especially
in diabetics; may cause acute renal failure; acts as
folic acid antagonist; may cause urolithiasis or crys-
talluria in acid urine
Midodrine No data No data 75%−80% 5−10 mg 5−10 mg No data Increases blood pressure 5 mg q. No data Dose for
q. 8 hr q. 8 hr 8 hr GFR 10−50
ml/min
Phosphodiesterase enzyme inhibitors
Amrinone 5 mg/kg/min 10 mg/kg/min 10%−40% 100% 100% 100% Adverse effects: thrombocytopenia; nausea, vomit- No data No data Dose for
daily dose <10 daily dose <10 ing in ESRD GFR 10−50
mg/kg mg/kg ml/min
Milrinone 0.375 mcg/kg/ 0.75 mcg/kg/min 100% 100% 100% No data No data Dose for
min GFR 10−50
ml/min
Vasodilators
Hydralazine 10 mg q.i.d. 100 mg q.i.d. 25% 100% 100% 100% May cause lupuslike reaction NC NC Dose for
GFR 10−50
ml/min
Minoxidil 2.5 mg b.i.d. 10 mg b.i.d. 20% 100% 100% 100% May cause pericardial effusion, fluid retention, hy- NC NC Dose for
pertrichosis, and tachycardia GFR 10−50
ml/min
Nitroprus- 1 mcg/kg/min 10 mcg/kg/min <10% 100% 100% 100% Cyanide is metabolic byproduct; may cause cyanide NC NC Dose for
side toxicity GFR10−50
ml/min
931
Table 5. Endocrine and metabolic agents
932
Hypoglycemic agents (oral)
Group toxicity: avoid all oral hypoglycemic agents on CRRT
Acarbose 25 mg t.i.d. 100 mg t.i.d. 35% 100% 50% Avoid Abdominal pain, nausea, vomiting, and flatulence Avoid Avoid Avoid
Acetohex- 250 mg q. 1,500 mg q. None Avoid Avoid Avoid Diuretic effect; may falsely elevate serum creatinine Avoid Avoid Avoid
amide 24 hr 24 hr level; active metabolite has a half life of 5−8 hr in
healthy persons and is eliminated by the kidney;
prolonged hypoglycemia in azotemic patients
Chlorprop- 100 mg q. 500 mg q24h 47% 50% Avoid Avoid Impairs water excretion; may cause prolonged hy- Avoid Avoid Avoid
amide 24 hr poglycemia in azotemic patients
Glibornuride 12.5 mg q. 100 mg q. 14 hr No data No data No data No data Avoid Avoid Avoid
24 hr
Gliclazide 80 mg q. 24 hr 320 mg q. 24 hr < 20% 50%− Avoid Avoid Avoid Avoid Avoid
100%
Glipizide 5 mg/day 20 mg b.i.d. 5% 100% 50% 50% Avoid Avoid Avoid
Glyburide 2.5 mg/day 10 mg b.i.d. 50% 100% 50% Avoid Avoid Avoid Avoid
Gimepiride 1 mg/day 8 mg daily 50% 100% 50% Avoid Avoid Avoid Avoid
Metformin 500 mg b.i.d. 2,550 mg/day 95% 100% Avoid Avoid Causes lactic acidosis Avoid Avoid Avoid
(b.i.d. or t.i.d.)
Repaglinide 0.5−1 mg 4 mg t.i.d. Avoid Avoid Avoid
Tolazamide 100 mg q. 250 mg q. 24.hr 7% 100% 100% 100% Diuretic effects Avoid Avoid Avoid
24 hr
Tolbutamide 1 g q. 24 hr 2 g q. 24 hr None 100% 100% 100% Impairs water excretion Avoid Avoid Avoid
OLYAEI & BENNETT
Troglitazone 200 mg/day 600 mg/day 3% 100% Avoid Avoid Hepatotoxic; decrease CSA level Avoid Avoid Avoid
Hypoglycemic agents (parenteral)
Dosage guided by blood glucose levels
Insulin Variable None 100% 75% 50% Renal metabolism of insulin decreases with azote- NC NC Dose for
mia GFR 10−50
Lispro insulin Variable No data 100% 75% 50% Avoid all oral hypoglycemic agents on CRRT NC NC NC
Hyperlipidemic agents
Atorvastatin 10 mg/day 80 mg/day <2% 100% 100% 100% Liver dysfunction, myalgia, and rhabdomyolysis as- NC NC NC
sociated with concurrent CSA/FK treatment
Bezafibrate 200 mg b.i.d. or q.i.d. 50% 50%− 25%− Avoid NC NC NC
400 mg SR q. 24 hr 100% 50%
Cholestyr- 4 gm b.i.d. 24 gm/day None 100% 100% 100% No data NC NC NC
amine
Clofibrate 500 mg b.i.d. 1,000 mg b.i.d. 40%−70% q. 6−12 hr q. 12−18 Avoid No data NC NC NC
hr
Colestipol 5 g b.i.d. 30 g/day None 100% 100% 100% No data NC NC NC
Fluvastatin 20 mg/day 80 mg/day <1% 100% 100% 100% No data NC NC NC
Gemfibrozil 600 b.i.d. 600 b.i.d. None 100% 100% 100% No data NC NC NC
Lovastatin 5 mg/day 20 mg/day None 100% 100% 100% No data NC NC NC
Nicotinic acid 1 g t.i.d. 2 g t.i.d. None 100% 50% 25% No data NC NC NC

Pravastatin 10−40 mg/day 80 mg/day <10% 100% 100% 100% No data NC NC NC
Probucol 500 mg b.i.d. < 2% 100% 100% 100% NC NC NC
Rosuvastatin 5−40 mg/day 40 mg/day 10% 100% 100% 50% 5 mg/day; maintenance, not to exceed 10 mg/day 50% 50% 50%
Simvastatin 5−20 mg/day 20 mg/day 13% 100% 100% 100% No data NC NC NC
Antithyroid drugs
Methimazole 5−20 mg t.i.d. 7 100% 100% 100% NC NC NC
Propylthio- 100 mg t.i.d. < 10 100% 100% 100% NC NC NC
uracil
Table 6. Gastrointestinal agents

Normal dosage
Starting dose Maximum dose renally >50 10−50 <10
Cimetidine 300 mg t.i.d. 800 mg b.i.d. 60% 100% 75% 25% Multiple drug-drug interactions (e.g., beta blockers, sulfonylurea, theophylline, war-
farin)
Famotidine 20 mg b.i.d. 40 mg b.i..d. 70% 100% 75% 25% Adverse effects: headache, fatigue, thrombocytopenia, alopecia
Lansoprazole 15 mg/day 30 mg b.i.d. None 100% 100% 100% Adverse effects: headache, diarrhea
Nizatidine 150 mg b.i.d. 300 mg b.i.d. 20% 100% 75% 25% Adverse effects: headache, fatigue, thrombocytopenia, alopecia
Omeprazole 20 mg/day 40 mg b.i.d. None 100% 100% 100% Adverse effects: headache, diarrhea
Rabeprazole 20 mg/day 40 mg b.i.d. None 100% 100% 100% Adverse effects: headache, diarrhea
Pantoprazole 40 mg/day 80 mg b.i.d. None 100% 100% 100% Adverse effects: headache, diarrhea
Ranitidine 150 mg b.i.d. 300 mg b.i.d. 80% 100% 75% 25% Adverse effects: headache, fatigue, thrombocytopenia, alopecia
Cisapride 10 mg t.i.d. 20 mg q.i.d. 5% 100% 100% 50%− Avoid with azole antifungal agents, macrolide antibiotics, and other P450 3A-4 in-
75% hibitors
Metoclo- 10 mg t.i.d. 30 mg q.i.d. 15% 100% 100% 50%− Neurotoxic; increase CSK/FK level
pramide 75%
Misoprostol 100 mcg b.i.d. 200 mcg q.i.d. 100% 100% 100% Adverse effects: diarrhea, nausea, vomiting; abortifacient agent
Sucralfate 1 g q.i.d. 1 g q.i.d. None 100% 100% 100% Adverse effects: constipation; decreased absorption of MMF
933
Table 7. Neurologic and anticonvulsant agents
934
Carbamazepine 2−8 mg/kg/day; adjust for side 2% 100% 100% 100% Plasma concentration: 4−12 mcg/ml; adverse effects: NC NC NC
effect and TDM double vision, fluid retention, myelosuppression
Clonazepam 0.5 mg t.i.d. 2 mg t.i.d. 1% 100% 100% 100% Although no dose reduction is recommended, the NC NC NC
drug has not been studied in patients with renal im-
pairment; recommendations based on known drug
characteristics not clinical trials data
Ethosuximide 5 mg/kg/day; adjust for side 20% 100% 100% 100% Plasma concentration: 40−100 mcg/ml; adverse ef- NC NC NC
effect and TDM fects: headache
Felbamate 400 mg t.i.d. 1,200 mg t.i.d. 90% 100% 50% 25% Adverse effects: anorexia, vomiting, insomnia, nausea Dose after Dose for Dose for
dialysis GFR < 10 GFR 10−
ml/min 50 ml/min
Gabapentin 150 mg t.i.d. 900 mg t.i.d. 77% 100% 50% 25% Less CNS side effects compared to other agents 300 mg 300 mg Dose for
load, then QID. GFR 10−
200−300 50
mg after
hemodi-
alysis
Lamotrigine 25−50 mg/day 150 mg/day 1% 100% 100% 100% Autoinduction, major drug-drug interaction with No data No data Dose for
valproate GFR 10−
50 ml/min
Levetiracetam 500mg b.i.d. 1,500 mg b.i.d. 66% 100% 50% 50% 250−500 Dose for Dose for
mg after GFR < 10 GFR 10−
OLYAEI & BENNETT
dialysis 50 ml/min
Oxcarbazepine 300 mg b.i.d. 600 mg b.i.d. 1% 100% 100% 100% Less effect on P450 compared to carbamazapine NC NC NC
Phenobarbital 20 mg/kg/day; adjust for side 1% 100% 100% 100% Plasma concentration: 15−40 mcg/ml; may cause NC NC NC
effect and TDM insomnia
Phenytoin 20 mg/kg/day; adjust for side 1% Adjust for renal failure and low Plasma concentration: 10−20 mcg/ml; may cause NC NC NC
effect and TDM Albumin nystagmus; check free phenytoin level
Primidone 50 mg 100 mg 1% 100% 100% 100% Plasma concentration: 5−20 mcg/ml NC NC NC
Sodium valpro- 7.5 to 15 mg/kg/day; adjust for 1% 100% 100% 100% Plasma concentration: 50−150 mcg/ml; side effects NC NC NC
ate side effect and TDM include weight gain, hepatitis; check free valproate
level
Tiagabine 4 mg/day; increase 4mg/day, 2% 100% 100% 100% Total daily dose may be increased by 4 to 8 mg at NC NC Dose for
titrate weekly weekly intervals until clinical response is achieved, or GFR 10−
up to 32 mg/day; the total daily dose should be given 50 ml/min
in divided doses two to four times daily
Topiramate 50 mg/day 200 mg b.i.d. 70% 100% 50% Avoid Avoid Avoid Dose for
GFR 10−
50 ml/min
Trimethadione 300 mg t.i.d. 600 mg t.i.d. or None q. 8 hr q. 8− 12 q. 12−24 Active metabolites with long half-life in ESRD; may No data No data Dose for
or q.i.d. q.i.d. hr hr cause nephrotic syndrome GFR 10−
50 ml/min
Vigabatrin 1 g b.i.d. 2 g b.i.d. 70% 100% 50% 25% Encephalopathy may arise with drug accumulation No data No data Dose for
GFR 10−
50 ml/min
Zonisamide 100 mg/day 100−300 mg 30% 100% 75% 50% Manufacturer recommends that zonisamide not be Dose for Dose for Dose for
q.d.−b.i.d. used in patients with renal failure (estimated GFR <50 GFR < 10 GFR < 10 GFR 10−
ml/min); dose recommendations for renal impair- ml/min ml/min 50 ml/min
ment based on clearance ratios: initial dose should be
100 mg/day; after 2 wk, the dose may be increased
to 200 mg/day for at least 2 wk; further dosage in-
creases to 300 mg and 400 mg/day can then be made
with a minimum of 2 wk between adjustments to
achieve steady state at each dosage level; zonisamide
doses of 100−600 mg/day appear effective for normal
renal function
935
OLYAEI & BENNETT
936
Table 8. Rheumatologic agents
Agent Normal dosage drug excreted failure with GFR (ml/min): Comments
Arthritis and gout agents
Allopurinol 300 mg q. 24 hr 30% 75% 50% 25% Adverse effects: interstitial nephritis, exfoliative Half dose No data Dose for GFR
dermatitis, and rarely, xanthine stones; renal excre- 10−50 ml/min
tion of active metabolite with half life of 25 hr in
normal renal function, half life 1 wk in patients
with ESRD
Auranofin 6 mg q24h 50% 50% Avoid Avoid Proteinuria and ephritic syndrome. NC NC NC
Colchicine Acute: 2 mg then 0.5 mg 5%−175 100% 50-100% 25% Avoid prolonged use if GFR < 50 ml/min NC No data Dose for GFR
q. 6 hr 10−50 ml/min
Chronic: 0.5−1.0 mg q.
24 hr
Gold sodium 25−50 mg 60%−90% 50% Avoid Avoid thiomalate proteinuria; ephritic syndrome, mem- NC NC Avoid
branous nephritis
Penicillamine 250−1,000 mg q. 24 hr 40% 100% Avoid Avoid Nephrotic syndrome One-third No data Dose for GFR
dose 10−50 ml/min
Probenecid 500 mg bid < 2% 100% Avoid Avoid Ineffective at decreased GFR Avoid No data Avoid
Nonsteroidal anti-Inflammatory drugs (NSAIDs)
Group toxicity: decreases renal function and platelet aggregation; may cause nephrotic syndrome, interstitial nephritis, hyperkalemia , sodium retention; carries increased risk of CVD, MI,
and stroke
Diclofenac 25−75 mg b.i.d. < 1% 50%−100 25%−50% 25% Group toxicity NC NC Dose for GFR
% 10−50 ml/min
Diflunisal 250−500 mg b.i.d. < 3% 100% 50% 50% Group toxicity NC NC Dose for GFR
10−50 ml/min
Etodolac 200 mg b.i.d. Negligible 100% 100% 50% Group toxicity NC NC Dose for GFR
10−50 ml/min
Fenoprofen 300−600 mg q.i.d. 30% 100% 100% 50% Group toxicity NC NC Dose for GFR
10−50 ml/min
Flurbiprofen 100 mg b.i.d. or t.i.d. 20% 100% 100% 50% Group toxicity NC NC Dose for GFR
10−50 ml/min
Ibuprofen 800 mg t.i.d. 1% 100% 100% 50% Group toxicity NC NC Dose for GFR
10−50 ml/min
Indomethacin 25−50 mg t.i.d. 30% 100% 100% 50% Group toxicity NC NC Dose for GFR
10−50 ml/min
Ketoprofen 25-−5 mg t.i.d. < 1% 100% 100% Group toxicity NC NC Dose for GFR
10−50 ml/min
Ketorolac 30−60 mg load then 15− 30%−60% 100% 50% 25-50% May cause acute hearing loss in ESRD NC NC Dose for GFR
30 mg q. 6 hr 10−50 ml/min
Meclofenamic 50−100 mg t.i.d. or q.i.d. 2%− 4% 100% 100% 50% Group toxicity NC NC Dose for GFR
acid 10−50 ml/min
Mefanamic acid 250 mg q.i.d. < 6% 100% 100% 50% Group toxicity NC NC Dose for GFR
10−50 ml/min
Nabumetone 1.0-2.0 g q. 24.hr < 1% 100% 50-100% 50% Group toxicity NC NC Dose for GFR
10−50 ml/min
937
938
Agent Normal dosage drug excreted failure with GFR (ml/min): Comments
Naproxen 500 mg b.i.d. < 1% 100% 100% 50% Group toxicity NC NC Dose for GFR
10−50 ml/min
Oxaproxin 1200 mg q. 24 hr < 1% 100% 100% 50% Group toxicity NC NC Dose for GFR
10−50 ml/min
Phenylbuta- 100 mg t.i.d. or q.i.d. 1% 100% 100% 50% Group toxicity NC NC Dose for GFR
zone 10−50 ml/min
Piroxicam 20 mg q. 24 hr 10% 100% 100% 50% Group toxicity NC NC Dose for GFR
10−50 ml/min
Sulindac 200 mg b.i.d. 7% 100% 100% 50% Active sulfide metabolite in ESRD NC NC Dose for GFR
10−50 ml/min
Tolmetin 400 mg t.i.d. 15% 100% 100% 50% Group toxicity NC NC Dose for GFR
10−50 ml/min
Biologic agents
Route of drug
clearance
Etanercept 50 mg S.C. weekly Hepatic 100% 100% 100% Increased risk of TB and other infections 100% 100% 100%
Infliximab 3 mg/kg IV at 0, 2, and 6 Hepatic 100% 100% 100% Increased risk of TB and other infections 100% 100% 100%
wk, then q. 8 wk; combine
with methotrexate
Adalimumab 40 mg S.C. Hepatic 100% 100% 100% May be continued during therapy; may increase to 100% 100% 100%
every other week 40 mg S.C. q. wk in patients not receiving concom-
itant methotrexate; may cause glomerulonephritis
Anakinra 100 mg/day S.C. Renal 100% 50% Avoid Renal impairment: plasma clearance is reduced up 100% 50% Avoid
to 75% in patients with severe or end stage renal
OLYAEI & BENNETT
disease (CCr less than 30 ml/min); no formal studies

have been conducted
Rituximab 375 mg/mm every Hepatic 100% 100% 100% Increased risk of TB and other infections 100% 100% 100%
other week
Table 9. Sedative agents
Dosage adjustment for renal
Route of drug Method of dosage adjustment
Drug Normal dosage failure with GFR (ml/min): Comments
clearance
>50 10−50 <10 HD CAPD CVVH
Barbiturates
Group toxicity: may cause excessive sedation.; increased osteomalacia in ESRD; charcoal hemoperfusion and hemodialysis more effective than peritoneal dialysis for poisoning
Pentobarbital 30 mg q. 6−8 hr Hepatic 100% 100% 100% Group toxicity NC No data Dose for GFR
10−50 ml/min
Phenobarbital 50−100 mg q. 8−12 hr Hepatic (renal) q. 8−12 hr q. 8−12 hr q. 12−16 Up to 50% unchanged drug excreted with urine Dose after hale normal Dose for GFR
hr with alkaline diuresis dialysis dose 10−50 ml/min
Secobarbital 30−50 mg q. 6−8 hr Hepatic 100% 100% 100% Group toxicity NC NC No data
Thiopental Anesthesia induction Hepatic 100% 100% 100% Group toxicity No data No data No data
(individualized)
Benzodiazepines
Group toxicity: may cause excessive sedation and encephalopathy in ESRD
Alprazolam 0.25−5.0 mg q. 8 hr Hepatic 100% 100% 100% Group toxicity NC No data No data
Clorazepate 15−60 mg q. 24 hr Hepatic (renal) 100% 100% 100% Group toxicity No data No data No data
Chlordiazepox- 15−100 mg q. 24 hr Hepatic 100% 100% 50% Group toxicity NC No data Dose for GFR
ide 10−50 ml/min
Clonazepam 1.5 mg q. 24 hr Hepatic 100% 100% 100% Although no dose reduction is recommended, NC No data NA
the drug has not been studied in patients with re-
nal impairment; recommendations are based on
known drug characteristics not clinical trials data
Diazepam 5−40 mg q. 24 hr Hepatic 100% 100% 100% Active metabolites desmethyldiazepam and NC No data NC
oxazepam may accumulate in renal failure; dose
should be reduced if given longer than a few
days; protein binding decreases in uremia
Estazolam 1 mg qhs Hepatic 100% 100% 100% Group toxicity No data No data NC
Au: define qhs

Flurazepam 15−30 mg qhs Hepatic 100% 100% 100% Group toxicity NC No data No data
Lorazepam 1−2 mg q. 8−12 hr Hepatic 100% 100% 100% Group toxicity NC No data Dose for GFR
10−50 ml/min
Midazolam Individualized Hepatic 100% 100% 50% Group toxicity NA NA NA
Oxazepam 30−120 mg q. 24 hr Hepatic 100% 100% 100% Group toxicity NC No data Dose for GFR
10−50 ml/min
Quazepam 15 mg qhs Hepatic No data No data No data Group toxicity No data No data No data
Temazepam 30 mg qhs Hepatic 100% 100% 100% Group toxicity NC NC No data
Triazolam 0.25−0.50 mg qhs Hepatic 100% 100% 100% Protein binding correlates with alpha-1 acid gly- NC NC No data
coprotein concentration
Benzodiazepine antagonists
Flumazenil 0.2 mg IV over 15 sec Hepatic 100% 100% 100% May cause excessive sedation and encephalopa- NC No data No data
thy in ESRD
Miscellaneous sedative agents
Buspirone 5 mg q.8 hr Hepatic 100% 100% 100% No data No data No data
Ethchlorvynol 500 mg qhs Hepatic 100% Avoid Avoid Removed by hemoperfusion; may cause exces- Avoid Avoid No data
sive sedation
939
940
Route of drug Method of dosage adjustment
clearance
>50 10−50 <10 HD CAPD CVVH
Haloperidol 1−2 mg q. 8−12 hr Hepatic 100% 100% 100% Adverse effects: hypertension, excessive sedation NC NC Dose for GFR
10−50 ml/min
Lithium car- 0.9−1.2 g q. 24 hr Renal 100% 50-75% 25-50% Nephrotoxic; adverse effects include nephrogenic Dose after NC Dose for GFR
bonate diabetes insipidus, nephrotic syndrome, renal dialysis 10−50 ml/min
tubular acidosis, and interstitial fibrosis; acute
toxicity when serum levels > 1.2 mEq/L; serum
levels should be measured periodically 12 hr
after dosing; half life does not reflect extensive
tissue accumulation; plasma levels rebound after
dialysis; toxicity enhanced by volume depletion,
NSAIDs, and diuretics
Meprobamate 1.2−1.6 g q. 24 hr Hepatic (renal) q. 6 hr q. 9−12 hr q. 12−18 Side effects: excessive sedation; excretion en- NC No data No data
hr hanced by forced diuresis
Table 10. Anti-Parkinson agents

Drug Normal dosage drug excreted failure with GFR (ml/min): Comments
Carbidopa 1−2 tablets t.i.d. or q.i.d. 30 100% 100% 100% Require careful titration of dose according to clini- No data No data No data
(30 mg/day to 200 cal response
OLYAEI & BENNETT
mg/day)
Levodopa 1−2 tablets t.i.d. or q.i.d. None 100% 50%−100% 50%− Active and inactive metabolites excreted in urine; No data No data Dose for GFR
(300 mg/day to 2,000 100% active metabolites with long half life in ESRD 10−50 ml/min
mg/day)
Rasagiline 1 mg/day <1% 100% 100% 100%
(MAO-b inhibi-
tor)
Table 11. Antipsychotic agents
Percentage of drug Dosage adjustment for renal
Drug Normal dosage Comments Method of dosage adjustment
excreted renally failure with GFR (ml/min):
>50 10−50 <10 HD CAPD CVVH
Clozapine 12.5 mg p.o.; 25−50 to 300−450 Metabolism nearly 100% 100% 100% No data No data Dose for GFR
mg/day by end of 2 weeks; complete 10−50 ml/min
maximum: 900 mg/day
Haloperidol 1−2 mg q. 8−12 hr Hepatic 100% 100% 100% Hypotension, excessive sedation. No data No data Dose for GFR
10−50 ml/min
Loxapine 12.5−50 mg I.M. q. 4−6 hr 100% 100% 100% Do not administer drug IV No data No data Dose for GFR
10−50 ml/min
Melperone olan- 5−10 mg Hepatic 100% 100% 100% Potential hypotensive effects No data No data Dose for GFR
zapine 10−50 ml/min
Phenothiazines
Group toxicity: orthostatic hypotension, extrapyramidal symptoms, and confusion
Chlorpromazine 300−800 mg q. 24 hr Hepatic 100% 100% 100% Group toxicity NC NC Dose for GFR
10−50 ml/min
Perphenazine 8 to 16 mg p.o., b.i.d., t.i.d., or Hepatic 100% 100% 100% Group toxicity No data No data Dose for GFR
q.i.d.; increase to 64 mg/day 10−50 ml/min
Promazine 20−100 mg q. 24 hr Hepatic 100% 100% 100% Group toxicity; excessive sedation No data No data Dose for GFR
may occur in ESRD 10−50 ml/min
Thioridazine 50−100 mg p.o. , t.i.d.; increase Hepatic 100% 100% 100% Group toxicity No data No data Dose for GFR
gradually; max dose 800 mg/day 10−50 ml/min
Trifluoperazine 1−2 mg b.i.d.; increase to no Hepatic 100% 100% 100% Group toxicity No data No data Dose for GFR
more than 6 mg/day 10−50 ml/min
Quetiapine 25 mg p.o., b.i.d.; increase in Hepatic 100% 100% 100% No data No data Dose for GFR
increments of 25−50 b.i.d or 10−50 ml/min
t.i.d. to achieve 300−400 mg/day
by day 4
Risperidone 1 mg p.o., b.i.d.; increase to 3 100% 100% 100% No data No data Dose for GFR
mg b.i.d. 10−50 ml/min
Thiothixene 2 mg p.o., t.i.d.; increase gradu- Hepatic 100% 100% 100% No data No data Dose for GFR
ally to 15 mg/day 10−50 ml/min
Ziprasideone 20−100 mg q. 12 hr Hepatic 100% 100% 100% No data No data Dose for GFR
10−50 ml/min
941
Table 12. Corticosteroid agents
942
Percentage of drug Method of dosage adjustment
excreted renally
>50 10−50 <10 HD CAPD CVVH
Group toxicity: may aggravate azotemia; adverse effects: sodium retention, glucose intolerance, hypertension
Betamethasone 0.5−9.0 mg q. 24 hr 5 100% 100% 100% Group toxicity NC NC NC
Budesonide No data None 100% 100% 100% Group toxicity NC NC NC
Cortisone 25−500 mg q. 24 hr None 100% 100% 100% Group toxicity NC NC NC
Dexamethasone 0.75−9.0 mg q. 24 hr 8 100% 100% 100% Group toxicity NC NC NC
Hydrocortisone 20−500 mg q. 24 hr None 100% 100% 100% Group toxicity NC NC NC
Methylprednisolone 4−48 mg q. 24 hr < 10 100% 100% 100% Group toxicity NC NC NC
Prednisolone 5−60 mg q. 24 hr 34 100% 100% 100% Group toxicity NC NC NC

Prednisone 5−60 mg q. 24 hr 34 100% 100% 100% Group toxicity NC NC NC
Triamcinolone 4−48 mg q. 24 hr No data 100% 100% 100% Group toxicity NC NC NC
OLYAEI & BENNETT
Table 13. Anticoagulant agents
60 mg over 1 hr then 20 mg/hr No data 100% 100% 100% Tissue-type plasminogen activator No data No data Dose for
Alteplase for 2 hr GFR 10−50
ml/min
Anistreplase 30 U over 2−5 min No data 100% 100% 100% NC NC NC
Aspirin 81 mg/day 325 mg/day 10% 100% 100% 100% GI irritation and bleeding tendency NC NC NC
Clopidogrel 75 mg/day 75 mg/day 50% 100% 100% 100% NC NC NC
Dalteparin 2,500 units S.C. 5,000 units S.C. Unknown 100% 100% NA Check anti-factor Xa activity 4 hr after 2nd NC NC NC
daily daily dose in patients with renal dysfunction
Dipyridamole 50 mg t.i.d. No data 100% 100% 100% NC NC NC
Enoxaparin 20 mg/day 30 mg b.i.d. 8% 100% 75%−50% 50% 1 mg/kg q. 12 hr for treatment of DVT; check NC NC NC
anti-factor Xa activity 4 hr after second dose
in patients with renal dysfunction; some evi-
dence of drug accumulation in renal failure
Fondaparinux 2.5mg S.C. daily 10 mg S.C. daily No data 100% 75%−50% Avoid Half life increases with renal failure; should be NC NC NC
used for patients with HIT only
Heparin 75 U/kg load then 15 U/kg/hr None 100% 100% 100% Half life increases with dose NC NC NC
Iloprost 0.5−2.0 ng/kg/min for 5−12 hr No data 100% 100% 50% NC NC NC
Indobufen 100 mg b.i.d. 200 mg b.i.d. < 15% 100% 50% 25% NC NC NC
Streptokinase 250 000 U load, then 100 000 U/hr None 100% 100% 100% NC NC NC
Sulfinpyrazone 200 mg b.i.d. 25-50% 100% 100% Avoid May cause acute renal failure; uricosuric effect NC NC NC
at low GFR
Sulotroban No data 52-62% 50% 30% 10% NC NC NC
Ticlopidine 250 mg b.i.d. 250 mg b.i.d. 2% 100% 100% 100% Adverse effects: severe neutropenia and NC NC NC
thrombocytopenia; decrease CSA level
Tranexamic acid 25 mg/kg t.i.d. or q.i.d. 90% 50% 25% 10% NC NC NC
Urokinase 4400 U/kg load then 4,400 U/kg No data No data No data No data NC NC NC
q. hr
Warfarin 5 mg/day Adjust per INR <1% 100% 100% 100% Monitor INR very closely; start at 5 mg/day; 1 NC NC NC
mg vitamin K IV over 30 min or 2.5−5 mg p.o.
can be used to achieve INR
943
Clinical Nephrotoxins
Renal Injury from Drugs and Chemicals
Third Edition
LIST OF ABBREVIATIONS
AA aristolochic acid AmB amphotericin B

AAN aristolochic acid nephropathy AMI acute myocardial infarction
AAP alanine aminopeptidase AMP adenosine monophosphate
AAS atomic absorption spectrometry Amph amphotericin
ABC ATP-binding cassette ANA antinuclear antibody
ABCD amphotericin B colloidal dispersion ANCA anti-neutrophil cytoplasmic antibody
ABLC amphotericin B in lipid complex ANDA abbreviated new drug application
ACAM N-cadherin ANF atrial natriuretic factor
ACE angiotensin converting enzyme ANT adenine nucleotide translocator
ACEI angiotensin converting enzyme inhibitor ANZDATA Australian and New Zealand Dialysis and
ACGIH American Conference of Governmental Transplant Registry
Industrial Hygienists AP alkaline phosphatase
AcP acid phosphate APA aminopeptidase 1 (angiotensinase)
ADH antidiuretic hormone APACHE Acute Physiology And Chronic Health
or alcohol dehydrogenase Evaluation
ADP adenosine diphosphate APC antigen presenting cell
ADPKD autosomal dominant polycystic kidney APhN acute phosphate nephropathy
disease APN aminopeptidase N
ADR adverse drug reaction AQP aquaporin
AE adverse event ARBs angiotensin II receptor antagonists
AER adverse event reaction ARDS acute respiratory distress syndrome
AGT alanine glyoxylate aminotransferase 5-ASA 5-aminosalicylic acid
AH-SOD hexamethyl-enediamine-conjugated super- AST aspartate aminotransferase
oxide dismutase ATHENA AIDS Therapy Evaluation National Centre
AHS allopurinol hypersensitivity syndrome ATG anti-thymocyte globulin
AIDS acquired immunodeficiency syndrome ATN acute tubular necrosis
AIN acute interstitial nephritis ATP adenosine triphosphate
AKI acute kidney injury AUC area under the curve
ALB albumin AV atrioventricular
α1-AG α1-acid glycoprotein AVP arginine vasopressin
α1-m α1-microglobulin AZT azidothymidine
α -KG α –ketoglutarate β1-m β1-microglobulin
ALT alanine aminotransferase BBA brush border antigen
Abbreviations
BBM brush border membrane CPK creatinine phosphokinase

BBMV brush border membrane vesicle cPLA2 cytosolic phospholipase A2
BC breast cancer CPP calcium phosphorus product
BCNU carmustine CREB cAMP response element-binding
bFGF basic fibroblast growth factor CRF chronic renal failure
BEN Balkan endemic npehropathy CRRT continuous renal replacement therapy
BID twice daily CsA cyclosporine A
BM basolateral membrane CSF colony-stimulating factor
BMDL benchmark dose low CSFL cerebrospinal fluid
BMI body mass index CT computer tomography
BMT bone marrow transplantation CTGF connective tissue growth factor
BN Brown-Norway CTIN chronic tubulointerstitial nephritis
BP blood pressure Curea urea clearance
BQ123 cyclo [Trp-Asp-Pro-Val-Leu] CVD cardiovascular disease
BSA bovine serum albumin CVVH continuous venovenous hemofiltration
BSP bromosulfophthalein CVVHD continuous venous-venous hemodialysis
BUN blood urea nitrogen Cx clearance of a marker
BW body weight CYP cytochrome P450
CA carbonic anhydrase dA-AAI 7(desoxyadenosin-N6-yl) aristolactam I
CABG coronary artery bypass graft dA-AAII 7(deoxyadenosin-N6-yl) aristolactam II
cADPR cyclic ADP-ribose DAC diacylglycerol
Calc calcitonin DCAA dichloroacetic acid
CAM cell adhesion molecule DCT distal convoluted tubule
cAMP cyclic adenosine monophosphate DCVC dichlorovinylcysteine
CAPD continuous ambulatory peritoneal dialysis dDAVP 1-desamino-8-D-arginine-vasopressin
CAPE caffeic acid phenethyl ester DDT dichlorodiphenyltrichloroethane
CaSR calcium sensing receptor DES diethyl stilbesterol
CC cytochemistry DEVD-CHO Asp-Glu-Val-Asp-aldehyde
CCB calcium channel blocker DFO desferoxamine
CCD cortical collecting duct dG-AAI 7(deoxyguanosine-N²-yl) aristolactam I
CCNU lomustine DGFR delayed graft function recovery
Ccr creatinine clearance DHEA-S dehydroepiandrosterone-sulfate
CD collecting duct DHG dehydrogenase
CDC Center for Disease Control and Prevention DHP vitamin D binding protein
CD-IC collecting duct intercalated cell DIGE difference in-gel electrophoresis
CdMT cadmium-metallothionein DISC death inducing signaling complex
CD-PC collecting duct principal cell DMARD disease modifying antirheumatic drugs
CFS colony-stimulating factor DMEM Dulbecco’s modified Eagle medium
CG density gradient centrifugation DMPC dimyristoyl phosphatidylcholine
CHD coronary heart disease DMPG dimyristoyl phosphatidylglycerol
CHF congestive heart failure DMPS dimercaptopropane 1 sulphonate
CHN Chinese herb nephropathy DMSA dimercaptosuccinic acid
CI confidence interval DMSO dimethylsulfoxide
CIN chronic interstitial nephritis DMT divalent metal transporter
CKD chronic kidney disease DMTU dimethylthiourea
CLOD clodronate DNP-SG S-(dinitropheny1)-glutathione
CM contrast media DOCA deoxycorticosterone acetate
CMIN contrast media induced nephropathy DPCPX 1,3-dipropyl-8-cyclopentylxanthine
CMV cytomegalovirus (selective adenosine A1 receptor antagonist)
CNI calcineurin inhibitors DPP dipeptidyl peptidase
CNS central nervous system DTL descending thin limb
cNOS constitutive nitric oxide synthase DTPA diethylenetriaminepentaacetic acid
CNT connecting tubule DVT deep vein thrombosis
COPD chronic obstructive pulmonary disease E217 β G estradiol-17 β -D-glucuronide
COX cyclooxygenase EBV Epstein Barr virus
CPH cephaloridine ecNOS endothelial nitric oxide synthase
946
Abbreviations
EDD extended daily dialysis HA hyaluronic acid

EDHF endothelium-derived hyperpolarizing factor H&E hematoxylin and eosin
EDRF endothelium-derived relaxing factor HCM hypercalcaemia of malignancy
EDTA ethylenediamine tetraacetic acid HCTZ hydrochlorothiazide
EDTA European Dialysis and Transplant Associa- HCV hepatitis C virus
tion HD hemodialysis
EEG electroencephalogram HDF hemodiafiltration
EG ethylene glycol HDL high-density lipoprotein
EGF epidermal growth factor HETE hydroxyeicosatetraenoic acid
EHDP etidronate HF hemofiltration
ELISA enzyme-linked immunosorbent assay HGF hepatocyte growth factor
EMA epithelial membrane antigen HGPRT hypoxanthine-guanine phosphoribosyl
EP E-prostanoid transferase
eNOS endothelial nitric oxide synthase HHV human herpes virus
ER endoplasmic reticulum HIT heparin-induced thrombocytopenia
ERK extracellular regulated kinase HIV human immunodeficiency virus
ERPF effective renal plasma flow HIVAN HIVassociated nephropathy
ESRD end-stage renal disease HLA human leukocyte antigen
estrone-S estrone sulfate HMW high molecular weight
ET endothelin HNL human neutrophil lipocalin
ET-1 endothelin-1 HO heme oxygenase
ETA endothelin A hOAT human organic anion transporter
ETB endothelin B HPT human proximal tubular cells
FACS fluorescence-activated cell sorting HPV human papillomavirus
FAD flavin adenine dinucleotide HR hazard ratio
FAK focal adhesion kinase HSP heat shock protein
FAT focal adhesion targeting HSV herpes simplex virus
FCS fetal calf serum hTERT human telomerase catalytic subunit
FDA Food and Drug Administration HUS hemolytic uremic syndrome
FE fractional excretion HUVEC human umbilical vein endothelial cells
FENa fractional excretion of sodium IAKI ischemic acute kidney injury
FEurea fractional excretion of urea IAP intestinal alkaline phosphatase
FF filtration fraction IARC International Agency for Research on Can-
FGS focal glomerulosclerosis cer
FHH familial hypercalcemic hypocalciuria IBD inflammatory bowel disease
FITC fluorescein isothiocyanate IBN ibandronate
FKBP FK-binding protein IC information component
FMN flavin mononucleotide ICAD inhibitor of caspase-activates Dnase
FPPS farnesyl pyrophosphate synthase ICAM intercellular cell adhesion molecule
FSGS focal segmental glomerulosclerosis ICC immunocytochemistry
G6PD glucose 6 phosphate dehydrogenase ICD International Classification of Diseases
GBM glomerular basement mmbrane ICU intensive care unit
GC gas chromatography IDDM insulin-dependent diabetes mellitus
GCCA gadolinium-containing contrast agents IEG immediate early gene response
GFR glomerular filtration rate IFN interferon
GI gastrointestinal Ig immunoglobulin
GLDH glutamate dehydrogenase IGF insulin-like growth factor
GMP guanosine monophosphate IL interleukin
GN glomerulonephritis IM intramuscular
GO glyoxylate oxidase IMCD inner medullary collecting ducts
GP glycoprotein iNOS inducible nitric oxide synthase
GSC glomerular sieving coefficient INR international normalized ratio
GSH glutathione IPD intermittent peritoneal dialysis
GSSG glutathione disulfide IP3 inositol 3,4,5 triphosphate
GST glutathione-S-transferase IPRK isolated perfused rat kidney
GT glutamyl transferase ISOM inner stripe outer medulla
947
Abbreviations
ITAM immunoreceptor tyrosine activated motive mPDS methylprednisolone

IV intravenous MN membranous nephropathy
IVIG intravenous immunoglobulin MPF+ 1-methyl-4-phenylpyridinium
IVP intravenous pyelography MPGN membranoproliferative glomerulonephritis
JCAHO Joint Commission on Accreditation of MPO myeloperoxidase
Healthcare Organizations MPT mitochondrial permeability transition
JGA juxtaglomerular apparatus MPTP l-methyl-4-phenyl-l,2,3,6-tetrahydropyri-
JNK c-Jun N-terminal kinase dine
KAP kidney androgen-regulated protein MR magnetic resonance
kD or kDa kilodalton Mr molecular weight
KDOQI Kidney Disease Outcomes Quality Initiative MRA magnetic resonance angiography
KIM kidney injury molecule MRI magnetic resonance imaging
L-Amph amphotericin B liposome MRP multidrug resistance-associated protein
LAP leucine aminopeptidase MRS magnetic resonance spectroscopy
LC lung cancer MRSA methicillin-resistant Staphylococcus aureus
LD50 lethal dose for 50% MS metabolic syndrome
LDH lactate dehydrogenase MT metallothionein
LDL low-density lipoprotein MTAL medullary thick ascending limb
LEHD-CHO Leu-Glu-His-Asp-aldehyde MTT methylthiotetrazole
LEW Lewis MTX methotrexate
LFA lymphocyte function-associated antigen NA not applicable
LFAB lipid formulation of amphotericin B NAA neutron activation analysis
LLC-PK1 renal epithelial cell line from porcine kidney NAC N-acetylcysteine
LMW low molecular weight NADC Na dependent α-ketoglutarate cotransporter
L-NAME N-nitro-l-arginine methyl ester NADPH nicotinamide adenine dinucleotide phos-
LOCM low osmolar contrast medium phate
LPS lipopolysaccharide NAG N-acetyl-β-D-glucosaminidase
LR likelihood ratio Na-K-ATPase sodium-potassium-ATPase
LRP LDL-receptor-related protein NAME nitric oxide synthase inhibitor
LT leukotriene NAPA N-acetyl procainamide
LTC4 leukotriene C4 NAPAP N-acetyl-p-aminophenol
LX lipoxin NAPQI N-acetyl-p-benzoquinoneimine
mAb monoclonal antibody NC No data: no change required
MAC minimal alveolar concentration NCAM neural cell adhesion molecule
MACS magnetic cell separation NCX Na+-Ca++ exchanger
magn. magnification NDA New Drug Application
MAP mitogen-activated protein NDMA N-methyl-D-aspartate
or mean arterial pressure NEP neutral endopeptidase
MAPK mitogen-activated protein kinase NF-AT-c nuclear factor of activating T lymphocytes
MATE multidrug and toxin extrusion NGAL neutrophil gelatinase-associated lipocalin
MCD medullary collecting duct NHE Na+/H+ exchanger isoform
MCP monocyte chemoattractant protein NIP NF-AT interacting protein
MD macula densa NK natural killer cells
or multiple dose NMN N-methylnicotinamide
MDA malondialdehyde NMTT N-methyl-tetrazole-thiol
MDCK Madin-Darby canine kidney nNOS neuronal nitric oxide synthase
MDFA 2,2-difluoro-2-methoxyacetic acid NO nitric oxide
MDMA methylenedioxymethamphetamine NOS nitric oxide synthase
MDR multidrug resistance NPT sodium-dependent phosphate transporter
MDRD modification of diet in renal disease NRF nuclear respiratory factors
MEK MAP kinase kinase NRK52E normal rat kidney epithelial cells
MHC major histocompatibility complex NRTI nucleoside analogue reverse transcriptase
MI myocardial infarction inhibitor
MM multiple myeloma NSA neuron specific enolase
MMF mycophenolate mofetil NSAID non-steroidal anti-inflammatory drug
MMP matrix metalloproteinases NSF nephrogenic systemic fibrosis
948
Abbreviations
OA osteoarthritis PPI proton pump inhibitor

OAT organic anion transporter PRA plasma renin activity
OCT organic cation transporter PR3 proteinase 3
OCTN organic cation/carnitine transporter PSS progressive systemic sclerosis
OD once daily PST proximal straight tubule
OFR oxygen-derived free radicals PT or PTC proximal tubular cells
OKT3 anti-CD3 monoclonal antibody PTCA percutanerous transluminal coronary angio-
OK opossum kidney plasty
OM outer medulla PTFE polymeric tetrafluoroethylene
OPN osteopontin PTH parathyroid hormone
OR odds ratio PTK protein tyrosine kinase
ORS oral rehydration solution PTU propylthiouracil
OST other solid tumours PTX polyester
OSHA Occupational Safety and Health Agency QD once daily
OSOM outer stripe outer medulla QTL quantitative trait locus
OSPS oral sodium phosphate solution RA rheumatoid arthritis
OTA ochratoxin RAAS renin-angiotensin-aldosterone system
PAA poly-L-aspartic acid RANTES regulated on activation, normal T-cell ex-
PAF platelet activating factor pressed and secreted
PAH para-aminohippurate RAP receptor-associated protein
PAS periodic acid Schiff RAS renin-angiotensin system
PAM periodic acid methenamine RBF renal blood flow
PBMC peripheral blood mononuclear cells RBFV renal blood flow velocity
PC Pneumocyctis carinii RCT randomized clinical trial
or prostate cancer rhIGF recombinant human insulin growth factor
PCE perchloroethylene RIA radio immunoassay
PCOP plasma colloid osmotic pressure RIS risedronate
PCP Pneumocyctis carinii pneumonia ROC receiver-operating characteristic
or phencyclidine ROR reporting odds ratio
PCSA planar cell surface area ROS reactive oxygen species
PCT proximal convoluted tubule RPF renal plasma flow
PD peritoneal dialysis RPGN rapidly progressive glomerulonephritis
PDB Paget’s disease of bone RR relative risk
PDGF platelet derived growth factor RTE renal tubular epithelial cells
PEG polyethylene glycol RVR renal vascular resistance
PEEP positive end-expiratory pressure RXR retenoic orphan receptor
PEM prescription event monitoring S- serum-
PEPCK phosphenol pyruvate carboxy-kinase SAPK stress-activated protein kinase
PEPT peptide cotransporter SAT sulfate-oxalate exchanger
PG prostaglandin SBP systolic blood pressure
PGA poly-L-glutamic acid Scr or SCr serum creatinine
PGC PPAR-gamma-coactivator SDS-PAGE sodium dodecyl sulphate - polyacrylamide
PGP P-glycoprotein gel electrophoresis
PH1 primary hyperoxaluria type 1 SEM standard error of the mean
PIDD primary immune deficiency diseases SHAKI Stuivenberg Hospital Acute Kidney Injury
PIH postischemic hydronephrosis SHARF Stuivenberg Hospital Acute Renal Failure
PIP phosphatidylinositide 4,5 biphosphate SHR spontaneously hypertensive rats
PK protein kinase SIADH syndrome of inappropriate antidiuretic
PKB protein kinase B hormone
PL phospholipase SKF550 (9-fluorenyl)-N-methyl-β-chloroethylamine
PLA placebo SLC Na+/Li+ countertransporter
PMA phorbol myrastate acetate SLE systemic lupus erythematosis
PMO postmenopausal osteoporosis SmPC summary of product characteristics
pmp per million population SMSA Standard Metropolitan Statistical Area
PPAR peroxisome proliferator-activated receptor SMZ sulfamethoxazole
PPD paraphenylene diamine SNGFR single nephron glomerular filtration rate
949
Abbreviations
SNS sympathetic nervous system VSMC vascular smooth muscle cells

SSc systemic sclerosis vWF von Willebrand factor
SVV small vessel vasculitis WHO World Health Organization
t2 elimination half-life XRF x-ray fluorescence
T3 triiodothyronin ZAG zinc-α2-globulin
TAC tacrolimus ZOL zoledronic acid
TAL thick ascending limb ZVAD-fmk Z-Val-Ala-Asp-fmk
T-bet T-box expressed in T-cells
TB tuberculosis
TBM tubular basement membrane
TCA trichloroacetic acid
TCO2 bicarbonate transport
TCR T-cell receptor
TDM therapeutic drug monitoring
TEA tetraethylammonium
TEER transepithelial electrical resistance
TER transepithelial resistance
TFR transferrin
TGA Therapeutic Goods Administration
TGF transforming growth factor
or tubuloglomerular feedback
Th T-helper cell
THP Tamm-Horsfall protein
TID trice daily
TLS tumor lysis syndrome
TLR toll-like receptors
TLV threshold limit value
TMA thrombotic microangiopathic anemia
TMP trimethoprim
TNAP tissue non-specific alkaline phosphatase
TNF tumor necrosis factor
TQ triple quantum
Treg regulatory T cells
TRF transferrin
TRP tubular reabsorption of phosphorus
TSC thiazide sensitive Na+-Cl– cotransporter
TSH thyroid-stimulating hormone
TTP thrombotic thrombocytopenic purpura
TTR transthryetin
TUNEL terminal deoxynucleotidyl transferase (Tdt)-
mediated dUTP nick end-labeling assay
TxA2 thromboxane A2
TxB2 thromboxane B2
U- urinary
UP:Ucr urine protein to creatinine ratio
USRDS United States Renal Data System
V1aR vasopressin V1a receptor
V2R vasopressin V2 receptor
VC vasoconstriction
VCAM vascular cell adhesion molecule
Vd volume of distribution
VD vasodilatation
VZV varicella zoster virus
VGEF vascular endothelial growth factor
VLA very late antigen
VRE vancomycin-resistant Enterococci
950
Clinical Nephrotoxins
Renal Injury from Drugs and Chemicals
Third Edition
I N D E X
Symbols acetylcholine 202, 205 cyclosporine nephrotox. 625

5-aminosalicylic acid (5-ASA) 409–412 acetylcystein dapsone 368
clinical aspects 412 mushroom nephrotoxicity 764 drugs 30
epidemiology 409–411 acetylcysteine epidemiology 29–30
pathophysiology 411–412 radiocontrast agents 706 gadolinium 709
pharmacological aspects 75 acidosis hemodynamically mediated nephro-
prevention 412 cadmium-induced renal effects 792 toxicity 30–32
prospective studies 409–411 gadolinium 712 heroin abuse 603
retrospective study 409 acrodynia (Pink disease) 816, 820 intensive care 29–42
actin mechanisms 6, 30–33
A chronic cyclosporine nephrotox. 644 mercury exposure 819
abacavir 387 actinonin paraphenylene diamine 874, 877
ABC transporters 59–61 animal model of septic injury 182 pentamidine 363
accelerated aging 239 acute interstitial nephritis prevention 35, 36
ACE inhibitors: See angiotensin proton pump inhibitors 571 radiocontrast agents 700
converting enzyme (ACE) acute kidney injury 29–42 risk factors 33, 34
inhibitors ACE inhibitors 482 SHARF score 6
acetaminophen acute tubular necrosis 426 strategies 35
analgesic nephropathy 403, 404 advanced age 33 suicide attempt 609
and NSAIDs 422 alcohol ingestion 503 sulfonamides 353
drug metabolism studies 63 aminoglycoside nephrotoxicity 276 tacrolimus nephrotox. 646
acetazolamide 495 amphetamine 608 trimethoprim-sulfamathoxazole 358
and lithium 739 animal model, measurement of injury acute phosphate nephropathy 579–594
pH-dependent reabsorption 47 183 acute renal failure: See acute kidney
acetochlor 224 APACHE score 6 injury
acetylation clinical relevance 3 acute tubular necrosis
sulfadiazine 355 cocaine abuse 605 acute kidney injury 31–32
INDEX
foscarnet 386 agricultural activity urinary biomarkers 109

paraphenylene diamine 875 silicon containing compounds 834 nonspecific
trimethoprim-sulfamathoxazole 358 agriculture urinary biomarkers 109
acyclovir 384 Balkan nephropathy 845, 846 alkalinization
acylcarnitinuria 312 Aiid methotrexate therapy 521
adefovir 387 genetics 144 poisoning 252
MRP transporters 59 alanine (L-) uptake alkalinization of urine
pharmacological aspects 75 beta-lactams 311 heroin abuse 604
adenosine alanine aminopeptidase sulfonamides 353
acute cyclosporine nephrotox. 623 cephalosporins 298 allenic norleucine 764
hydronephrotic kidney 189 urinary biomarkers 109 allergic interstitial nephritis
microcirculation model 187 alanine aminotransferase acute kidney injury 32
radiocontrast agents 702, 703 mercury exposure 816 ALLHAT study 439
adenosine receptor albumin allopecia
A1:knockout mouse model 177 cadmium-induced renal effects 791 allopurinol therapy 469
A3:animal model of septic injury 182 mercury exposure 820, 821 allopurinol 469–472
A3:knockout mouse model 177 urinary biomarkers 103–104 acute cyclosporine nephrotox. 623
adenylate cyclase albuminemia histopathology 470
cell culture 226 aminoglycoside nephrotoxicity 269 pathogenesis of nephropathy 470–471
fluoride toxicity 541 albuminuria prevention of nephropathy 471–472
adrenergic agonist agents heroin abuse 596 prognosis of nephropathy 471–472
dosing in renal failure 927 organic solvents 831 tubular reabsorption 48
adrenergic stimulation silicon containing compounds 834, alpha-ketoglutarate
acute cyclosporine nephrotox. 622 835 organic anion transport 51–55
adriamycin 307 urinary biomarkers 103–104 alpha epithelial sodium channel
aflatoxin alcohol abuse 609 knockout mouse model 178
Balkan nephropathy 847 and analgesics 406 Alport’s syndrome
African nephrotoxins 859–870 alcohol consumption chronic cyclosporine nephrotox. 643
amphetamines 866–867 clinical relevance 17 altered intraglomerular dynamics
cantharidin 862–863 alcohol ingestion 501–504 in acute kidney injury 8
Cape aloe 863–864 alcohols alternative medicine
copper sulphate 865–866 organic solvents 828 Africa 860
cresols 862 aldosterone aluminum
Eastern Cape 864 chronic cyclosporine nephrotox. 632 chelation therapy 257
ethylene glycol 867–868 diuretics 498 in renal failure 886–887
impila 863 vasoconstriction 483 amalgams, dental fillings 812, 821
mercury 864–865 alendronate 548 Amanita phalloides 763
paraphenylene diamine 865 organic anion transport 52 Amatoxins 763
paraquat 866 pharmacokinetics 549 ambisome
potassium dichromate 861–862 preclinical toxicity 553 amphotericin B therapy 338
senecio 864 alfalfa amikacin 267
sodium bromate 865 and paraphenylene diamine 872 amiloride 498
Soweto 863 alkaline battery workers and amphotericin B 344
Sudan 865 cadmium-induced renal effects 786, and lithium 733, 740
violet tree 868 788 organic cation transport 56, 57
Zimbabwe 863 alkaline phosphatase amino-levulinic acid
agmatine aldehyde 182 intestinal type 791, 800 lead nephropathy 774
952
INDEX
urinary biomarkers 94 cephalosporins 303 vasoconstriction 328

amino-nitrogen amiodarone ampicillin 295, 296, 304
cadmium-induced renal effects 791, tubular secretion 62 amprenavir 390
795 amitriptyline amyloid A 600
aminoaciduria pH-dependent reabsorption 47 amyloidosis
aristolochic acid nephropathy 758 amoxicillin 295, 296 5-aminosalicylic acid 409, 412
cadmium-induced renal effects 790 immune response 139 heroin abuse 596, 599–601
didanosine 389 amphetamine 608 analbuminemia
aminoglycosides 267–280 pH-dependent reabsorption 47 glomerular filtration 46
absorption 269 amphetamines 866 analgesic nephropathy 400–409
acute kidney injury 31–32 amphotericin B 324–352 abuse of analgesics 400
and beta-lactams 313 and aminoglycosides 343 analgesic mixtures 400–403
and ciprofloxacin 369, 370 and beta-lactams 313 analgesic syndrome 406
and cyclosporine 626, 627 and ciprofloxacin 370 and Balkan nephropathy 848
and pentamidine 364 and cyclosporine 343, 626, 627 and NSAIDs 422
and trimethoprim-sulfamathoxazole and cyclosporine therapy 326 Australia 403, 408
358, 360 and pentamidine 364 Belgium 403, 408
animal model of septic injury 180 and trimethoprim-sulfamathoxazole case-control studies 400–402
apoptosis 274 360 clinical aspects 404–407
biochemical pathology of nephrotox- animal model of septic injury 180 CT scan 408
icity 275–276 azotemia 325 Czech Republic 404
cell culture 232 cell culture 233, 238 diagnosis 407–408
clinical relevance 10 cell membrane effects 328–330 dosing in renal failure 926
cortical uptake 270 children 339 drug metabolism studies 63
distribution 269 clinical manifestations 324–327 epidemiology 400–404
dose regimens 277–279 clinical use 342–344 France 403
dosing in renal failure 920 concentrating ability 326 Germany 409
drug metabolism studies 63 dosing regimen 325 Hungary 404
elimination 270 electrolyte disturbances 326–327 Malaysia 404
endocytosis 48 hypokalemia 326 nephrotoxicity of different kinds of
epidemiology 268 incidence 325–326 analgesics 402–403
glomerular filtration 46 infusion rate 325 New Zealand 403
immune response 138 lipid formulations 335–341 papillary calcifications 408
immunologic pathology of nephrotox- LLC-PK1 cell line 336 pathophysiology 404
icity 276–277 measures to reduce nephrotoxicity pharmacological aspects 77
morphological pathology of nephro- 332–341 phenacetin 408
toxicity 272–275 mechanisms of nephrotoxicity prevention 408–409
once daily regimen 268, 278–279 328–333 renal imaging 407–408
pharmacokinetics 269–270 pathological findings 327 Slovakia 404
prevention of nephrotoxicity 279–280 pharmacological aspects 74 South Africa 404
proximal tubule cell transport physiological effects 330–331 Sweden 403, 408
270–271 renal tubular acidosis 327 Switzerland 409
renal function 268 risk factors 325–326 Thailand 404
renal transport 270–272 salt supplementation 332, 333, 342 United States 403
risk factors for nephrotoxicity sodium bicarbonate supplementa- analine 873
268–269 tion 331 anaphylaxis
aminopyrine-N-demethylase urinary concentration defects 326 proton pump inhibitors 572
953
INDEX
anemia juxtaglomerular apparatus 188 antibacterial agents

analgesic nephropathy 406 angiotensin II 483 dosing in renal failure 920–925
Balkan nephropathy 850 and lithium 740 antibiotics 431
cadmium-induced renal effects 792, cell culture 225 amphotericin B 324
797 chronic cyclosporine nephrotox. 633 clinical relevance 10
lead poisoning 774 diuretics 496 antibody-mediated glomerulonephritis
anesthetic agents 537–546 hydronephrotic kidney 189 cocaine abuse 606
and cyclosporine 627 angiotensin II receptor antagonists anticancer drugs 511–536
and radiocontrast agents 537 483–491 anti-VEGF agents 524–526
clinical implications 542–543 acute kidney injury 31 antimetabolites 520–522
fluoride elimination 541–542 aristolochic acid nephropathy 762 antitumor antibiotics 522–523
fluoride toxicity 540–541 chronic cyclosporine nephrotox. 632 bevacizumab 524
metabolism of inhaled 538–542 dosing in renal failure 928 carboplatin 512, 516–517
pediatric patients 542 hydronephrotic kidney 190 cisplatin 512, 513–516
renal pharmacology 538 microcirculation model 185 cyclophosphamide 512, 517
Angel Dust aniline hydroxylase gemcitabine 521–522
pH-dependent reabsorption 47 cephalosporins 303 ifosfamide 512, 517–518
phencyclidine 607 animal models 175–222 immunotherapy 523–524
angiitis chronic cyclosporine nephrotox. 631 interferons 512, 523–524
amphetamine 608 hydonephrotic kidney 187–189 interleukins 512, 523
angiotensin 235 T allele in vitro perfused juxtamedullary methotrexate 512, 520–521
genetic susceptibility 14 nephron 186–187 mitomycin 512, 522–523
angiotensin converting enzyme (ACE) ischemia-reperfusion 198–203 nitrosoureas 518–520
inhibitors 481–494 ischemic injury 178–180 oxazaphosphorines 517–518
acute interstitial nephritis 482 isolated perfused juxtaglomerular radiation nephritis 526–527
acute kidney injury 31 apparatus 193 sorafenib 525
and aminoglycosides 269 isolated perfused mouse kidney streptozotocin 512, 518–519
and cyclosporine 620, 626 194–206 sunitib 525
animal models 175 isolated perfused rat kidney 194–206 anticoagulation agents
antiproteinuric effects 489–491 isolated renal microvessels 190–193 D-penicillamine nephropathy 467
aristolochic acid nephropathy 762 knockout mouse models 176–177 dosing in renal failure 943
cell culture 231 measurement of injury 181–184 anticonvulsant agents
clinical relevance 11 nephrotoxic ARF model 180 dosing in renal failure 934–935
dosing in renal failure 927 nephrotoxic injury 203 antidepressants (tricyclic)
elanapril 231 proximal vs. distal tubular injury 184 pH-dependent reabsorption 47
fall in glomerular filtration rate 483 renal microcirculation 184–194 antidiuresis
fetal nephrotoxicity 488 septic ARF model 180–181 lithium treatment 730
gadolinium 715 two-photon microscopy 193–194 antidiuretic hormone
membranous glomerulopathy 482 types of renal injury 178–181 fluoride toxicity 541
microcirculation model 185 whole animal models 176–184 isolated perfused rat kidney 198
NSAIDs 427, 430, 438 annexin 230, 236 NSAIDs 428
pentamidine 365 oxalate 754 antiepileptic drugs
pre-existing renal failure 487–488 anorexia immune response 138
pregnancy 488 sulfadiazine 355 antifungal agents
renal function preservation 489–491 anoxia 305 cell culture 233
renography 489 antacids dosing in renal failure 923–924
angiotensin I 483 pharmacokinetics in uremia 915 antigen presenting cells
954
INDEX
proton pump inhibitors 572 fusion inhibitors 391 tacrolimus nephrotox. 648
antiglomerular basement membrane ganciclovir 385 arginine vasopressin
antibodies 116 non-nucleoside reverse transcriptase lithium treatment 728
antihelmintic preparations 817 inhibitors 389 aristolochic acid nephropathy 757–763,
antihistamines nucleoside reverse transcriptase 868
paraphenylene diamine 877 inhibitors 387 and Balkan nephropathy 760, 847, 853
antihypertensive drugs penciclovir 385 botanicals
ACE inhibitors 481–494 protease inhibitors 390 Aristolochia Fang 757
and lithium 740 ribavirin 391 Magnolia officinalis 758
dosing in renal failure 927–931 rimantadine 391 Stephania tetrandra chi 758
NSAIDs interaction 429 valacyclovir 384 clinical relevance 16
antimalarials anuria experimental 761–762
artemisinin 860 ciprofloxacin 370 C3H/He mice 761
antimetabolites 520–522 neonatal New Zeeland white rabbits 761
antimonial salt ACE inhibitors 488 Wistar rats 761
pentamidine 364 sulfonamides 353 urinary tract carcinomas 759–760
antineutrophil cytoplasmic antibodies aplastic anemia Artemisia annua 860
(ANCA) D-penicillamine therapy 465 arteriopathy
silicon containing compounds 832, gold salt therapy 460 chronic cyclosporine nephrotox. 630
835 paraphenylene diamine 876 arteriosclerosis
urinary biomarkers 116 apoptosis Balkan nephropathy 851
antinuclear antibodies aminoglycoside nephrotoxicity 274 arthralgia
silicon containing compounds 836 amphotericin B therapy 329 amphetamine 608
antioxidants animal model of ischemic injury 178 arthritis agents
aminoglycoside nephrotoxicity 279 animal models 175 dosing in renal failure 937
beta-lactams 310 anti-apoptotic Bcl-X(L) 200 ascorbic acid
antiParkinson agents aristolochic acid nephropathy 762 tubular reabsorption 48
dosing in renal failure 940 Balkan nephropathy 849 Asia
antiplatelet agents cell culture 229, 230, 232–236 lead nephropathy 776
D-penicillamine nephropathy 467 cellular mechanisms 156 aspartate aminotransferase
antipsychotic agents chronic cyclosporine nephrotox. 634 cocaine abuse 606
dosing in renal failure 941 HIV nephropathy 603 mercury exposure 816
antithymocyte globulin 693 pharmacological aspects 77 aspirin
antithyroid drugs pro-apoptotic Bax 200 analgesic nephropathy 403, 404
dosing in renal failure 933 silicon containing compounds 835 and NSAIDs 435
antitumor antibiotics 522–523 tacrolimus nephrotox. 648 microcirculation model 185
antiVEGF agents 524–526 TUNEL staining 157 tubular secretion 62
antiviral agents 383–398 aquaporin ataxia
acute kidney injury 31 knockout mouse model 178 lithium treatment 741
acyclovir 384 lithium treatment 729 ATG: See antithymocyte globulin
amantadine hydrochloride 391 arachidonic acid atomic absorption spectrometry
antiretroviral agents 387–391 prostaglandins 421, 483 mercury determination 815
cidofovir 385 aranidipine 190 atopic dermatitis
dosing in renal failure 924–925 arbekacin 267 chronic cyclosporine nephrotox. 643
experimental 384, 386, 387, 389 arginine (L-) ATP depletion
famciclovir 385 acute cyclosporine nephrotox. 621 models of ischemia 198
foscarnet 386 chronic cyclosporine nephrotox. 634 ATP levels
955
INDEX
cell culture 229, 231, 233, 237 B soil 848

atractyloside 161, 863 B-cells treatment 853
atrial natriuretic factor (ANF) polyclonal activation 137 urban population 846
acute cyclosporine nephrotox. 623, backcrossing viruses 846
628 knockout mouse model 177 water 847
hydronephrotic kidney 189 bacteria wells 848
models of ischemia 202 Balkan nephropathy 847 barbaloin 864
radiocontrast agents 706 Bacteroides fragilis 297, 298 barbiturate
atrophy Balkan nephropathy 844–858 acute kidney injury 609
aristolochic acid nephropathy 759 agriculture 848 pH-dependent reabsorption 48
atypia and analgesic nephropathy 848 barbiturates
aristolochic acid nephropathy 759 and aristolochic acid nephropathy dosing in renal failure 939
auranofin 460, 463, 464 760, 847 barium hydroxide
aurothiomalate (sodium) 460 animals 846 CO2 absorption 540
Australia biological agents 846–847 basiliximab 692
lead nephropathy 775, 776 cadmium 847, 848 basolateral membrane 225, 227, 231,
autoantigens chromosomes 846 233, 235
T-cell response 135 chronology 845 Bax
autocoids 420 clinical features 850 cellular mechanisms 161
autoimmune diseases clusters 846 Bcl-2 protein
acute cyclosporine nephrotox. 626 cyclosporine 848, 849 acute cyclosporine nephrotox. 623
chronic cyclosporine nephrotox. 640 demographic data 845 cell culture 232, 233
D-penicillamine induced 468 diagnosis 852–853 cellular mechanisms 161–162
gold salts 140–143, 462 environment 846, 847–848 Behçet’s syndrome
immune response 132 epidemiology 844–846 chronic cyclosporine nephrotox. 643
immunomodulators 685 ethnic differences 845 bendrofluazide 499
mechanisms 142–143 etiology 846–848 and lithium 740
mercury 140 exposure 845 benzidine 604
mercury exposure 817 fertilizers 848 benzodiazepine antagonists
metal-induced 143–144 genetics 846 dosing in renal failure 939
autoreactive T-cells 136 geographical distribution 844 benzodiazepines 609
Averrhoa carambola 901 hydrogeology 847 dosing in renal failure 939
azarcon 860 imaging 852 benzoquinone
azathioprine immigration 846 paraphenylene diamine 873
and cyclosporine 619, 629 immunology 846 benzylpenicillin 295, 296, 313
D-penicillamine nephropathy 466, incidence 846 bestatin
467 laboratory findings 850–852 tubular reabsorption 48
azlocillin 369 lead poisoning 847, 848 beta-blockers
azotemia macroscopic features 848 dosing in renal failure 928–929
ACE inhibitors 487 morphology 848–849 beta-galactosidase
acyclovir 384 mortality 846 mercury exposure 820
cocaine abuse 606 mosaic distribution 845, 846 beta-lactams 293–322
foscarnet 386 pathomorphological changes 848–850 alterations of cellular biochemical
sulfonamides 353, 497 pesticides 848 processes 310–313
aztreonam 295, 299, 307 prevalence 846 and aminoglycosides 295, 310
prevention 853 antioxidants 310
religious differences 845 beta-lactamase 314
956
INDEX
cell culture 233 renal transport 549–552 hair waving 865

clinical toxicity 313 black grape bronchial asthma 460
cytochrome P-450 305 acute cyclosporine nephrotox. 623 brush border membrane vesicles
effects on endoplasmatic reticulum Black population beta-lactams 311
302–304 predisposition to heroin nephropathy Bruxism 812
effects on lysosomes 304 597, 601 Bulgaria
effects on mitochondria 304, 306 bladder Balkan nephropathy 844–846
effects on plasma cell membrane 302 cyclophosphamide therapy 517 Cakonica, Balkan nephropathy 845
effects on renal brush border 304 blood lead Vratza, Balkan nephropathy 844
gluconeogenesis 312 lead nephropathy 774 bumetanide 190, 496
glutathione 306–307 blood pressure and lithium 739
immune response 138 ACE inhibitors 481–491 drug metabolism studies 63
interactions with other drugs 313–314 blood urea nitrogen buthionine sulfoximine 307
intracellular concentration 304–305 animal model, measurement of injury butyrate 313
lipid metabolism 312–313 181
lipid peroxidation 309–310 urinary biomarkers 97 C
mechanisms of nephrotoxic action bone-G1a protein c-Jun N-terminal kinase
304–310 cadmium-induced renal effects 793 cell culture 235
nephrotoxicity 295–299 bone biopsy cadherins
prevention of clinical toxicity 314–315 lead nephropathy 778 urinary biomarkers 113
protein degradation 312–313 bone decalcification cadmium 785–810
radical scavengers 310 cadmium-induced renal effects 790 acute toxicity 787–788
reactive oxygen species 307–309 bone demineralization auto-antibodies against metal-
reactivity of the nucleus 306 cadmium-induced renal effects 803 lothionein 804
renal bioactivation 305 bone fractures Balkan nephropathy 847, 848
structure and renal toxicity 299–302 cadmium-induced renal effects 802 Belgium 796–803
tubular reabsorption 48 bone lead biomarkers 789
betamipron 299 lead nephropathy 775 calcium metabolism 802
bevacizumab 524 bone marrow depression carcinogenicity 788
biapenem 295 allopurinol therapy 469 cell culture 234–235
biliary cirrhosis, primary bone marrow transplantation China 803–804
chronic cyclosporine nephrotox. 643 acute cyclosporine nephrotox. 626 D-penicillamine therapy 465
D-penicillamine therapy 465, 466 chronic cyclosporine nephrotox. 640 endocytosis 48
binding affinity bone uptake exposure 785–787
aminoglycosides 271 fluoride elimination 541 Germany 803
bioavailability 915 bongkrekic acid 161 in food 786
biologic agents bosentan 204 itai-itai disease 790
dosing in renal failure 938 Bosnia Japan 790–796
biomakers: See urinary biomarkers Balkan nephropathy 844–846 long-term exposure 788
biotin bradykinin 483 metallothionein
tubular reabsorption 48 acute cyclosporine nephrotox. 624 cell culture 234, 238
bisphosphonates 547–566 brain toxicity nephrotoxicity 788–789
clinical renal toxicity 554–557 mercury exposure 815 reproductive toxicity 788
histopathology 558–562 BrdU 229, 232 Singapore 803
organic anion transport 52 bricklayers 832 Sweden 789–790
pharmacokinetics 549–552 British Anti-Lewisite 821 toxic effects 787–788
preclinical renal toxicity 552–554 bromate toxicokinetics 786–787
957
INDEX
urinary biomarkers 104 candoxatrilat cathinonine

urinary cadmium concentration 795 acute cyclosporine nephrotox. 628 khat leaf toxicity 868
USA 803 cannabis 867 cation shifts
caffeine 434 cannulas, glass models of ischemia 198
analgesic nephropathy 403 isolated perfused rat kidney 196 CD cells: See T-cells
calcification cantharidin 862–863 cecal ligation
oxalate 752–754 Cape aloe 863–864 animal model of septic injury 181
calcific foci captopril 482–491 cefaclor 297, 298, 300, 306
amphotericin B therapy 327 tacrolimus nephrotox. 647 cefamandol 297, 305
calcineurin alpha-isoform 632 carambola 901 cefazolin 297, 300, 306
calcineurin inhibitors 618–649 carbacephems 295, 298 cefclidin 298
and proton pump inhibitors 570 carbapenems 298 cefepime 295, 298, 305, 312
calcitonin 226 carbenicillin 296 cefixime 297
calcium carbon tetrachloride 828 cefmetazole 295, 298
aminoglycoside nephrotoxicity 279 carboplatin 512, 516–517 cefodizime 297
cadmium-induced renal effects 794, carborundum cefonicid 297, 300
802 silicon containing compounds 832 cefoperazone 297
calcium phosphorus product 588 carcinogenity cefoselis 298, 305, 312
cell culture 232–234 aristolochic acid nephropathy 760 cefotaxime 297, 299, 300, 301, 305, 307
calcium channel blockers carcinoma cefotetan 295, 298
acute cyclosporine nephrotox. 625, bladder 876 cefotiam 295, 297, 300, 305
627 cell culture 224 cefoxitin 295, 298, 301
and amphotericin B 332 papillary transitional cell 760 cefpirome 298
animal model of ischemic injury 178 urothelial 406 cefsulodin 295, 301, 307
cell culture 230 aristolochic acid nephropathy 759 ceftazidime 295, 297, 301, 306, 307
dosing in renal failure 929–930 Balkan nephropathy 846, 850 ceftizoxime 297, 299
radiocontrast agents 705 cardiac failure 427 ceftriaxone 297, 299, 305, 314
tacrolimus nephrotox. 646 carmustine 512, 519 cefuroxime 297, 299, 301, 305
calcium ionophore 202 carnithine celecoxib 424, 428, 431, 437
calcium oxalate 749–756 acute cyclosporine nephrotox. 623 cell adhesion molecules
deposition 581 carnitine 312 urinary biomarkers 112–114
calcium phosphorus product and antiretroviral agents 389 cell culture
acute phosphate nephropathy 588 organic cation transport 58 aminoglycosides 232–233
Callilepsis Laureola 863 carvedilol amphotericin B 233–234
calomel (mercurous chloride) 817 aminoglycoside nephrotoxicity 279 cadmium 234
calpain 161 caspase cephalosporins 233
pharmacological aspects 74 animal model of septic injury 182 cisplatin 231–232
calpastatin 161 cell culture 229, 232, 236 co-culture 228–229
Calvert formula cellular mechanisms 159–160 epithelial cells 225, 239
carboplatin therapy 516 knockout mouse model 177 growth surface 227
cAMP catalase hemoglobin 237
lithium treatment 738 beta-lactams 310 immortalization 225, 226
responsive element binding protein cell culture 231, 234, 236 interferons 236–237
(CREB) 164 catecholamines medium 226–227
campath-1H 692 acute cyclosporine nephrotox. 622 medium perfusion 228
Candida albicans cocaine abuse 605 mercury 235
amphotericin B therapy 324, 336, 337 Catha Edulis 868 mycotoxins 235–236
958
INDEX
myoglobin 237 cephamycin 298 tacrolimus nephrotox. 649

oxygen 227 cephapirin 297, 299, 305 chronic interstitial nephritis
perfusion culture 228, 239 cepirome 301 proton pump inhibitors 574
primary cells 225, 226, 238 cerebrovascular accident chronic kidney disease
renal cell injury 239 cocaine abuse 605 aminoglycosides 269, 278
renal cells 239 ceruloplasmin proton pump inhibitors 574
static culture 228 copper sulphate 866 smoking 897
cell culture models channeling chrysiasis
drug transport studies 45 pharmacovigilance 88 gold salt therapy 460
cell proliferation 226, 229–232, 235–238 chelation therapy chrysotherapy 460
cellular injury beta-lactams 308, 310 cidofovir 386
pharmacological aspects 77–78 copper sulphate 866 cilastatin 295, 298
cellular mechanisms of nephrotoxicity lead nephropathy 775, 780 acute cyclosporine nephrotox. 628
155–172 mercury exposure 819, 821 cimetidine 367, 539
Bcl2 161–162 poisoning 257 drug metabolism studies 63
caspases and cell death 159–161 chemokines organic cation transport 56, 58, 62
defects in energy generation 158–159 proton pump inhibitors 572 ciprofloxacin 368
disruption of energy production Chinese herb nephropathy: See aristolo- and aminoglycosides 370
157–158 chic acid nephropathy and amphotericin B 370
mitochondrial dysfunction 158–159 chloralkali industry 812, 813, 820 and cephalosporin 369
morphology of injury 156–157 chloride channels and cisplatin 370
pathophysiology 157 hydronephrotic kidney 189 and cyclosporine 370
stress response 162, 162–165 chloroacetaldehyde and non-steroidal anti-inflammatory
structural abnormalities 159 ifosfamide therapy 517 drugs 370
Centre for Adverse Reactions Monitor- chlorocrotylglycine 764 and penicillin 369
ing chloroform 828 gastrointestinal tract absorption 368
proton pump inhibitors 571 chloroquine cirrhosis
cephacetrile 299 pH-dependent reabsorption 47 NSAIDs 427
cephalexin 297, 300, 305, 306, 357 chlorothiazide 496 cisplatin 513–516
organic cation transport 57 and lithium 740 and aminoglycosides 269
cephaloglycin 296, 299, 300, 305, 306 pH-dependent reabsorption 47 and beta-lactams 313
cephaloridine 294, 295, 297, 301, 306, chlorpheneramine maleate 877 and ciprofloxacin 370
307 chlorpromazine 609 animal models 175
organic cation transport 58 chlorthalidone 498 cell culture 231–232
cephalosporin 296 cholangitis cellular mechanisms 157, 158
and aminoglycosides 269 allopurinol therapy 469 pharmacological aspects 76
and ciprofloxacin 369 cholesterol tubular secretion 62
cell culture 233 acute cyclosporine nephrotox. 624 urinary biomarkers 115
dosing in renal failure 920–921 amphotericin B binding 328, 336 citrinin
first-generation 296 cell culture 233 Balkan nephropathy 847
fourth-generation 298 choline clavulanic acid 295
organic cation transport 58 organic cation transport 57, 58 cleaning agents 828
second-generation 297 tubular reabsorption 48 clindamycin 356
third-generation 297 chromium and aminoglycosides 269
tubular reabsorption 48 in renal failure 888 clinical relevance of drug nephrotoxic-
Cephalosporium acremonium 294 chronic allograft nephropathy ity 3–28
cephalothin 294, 299, 301, 305, 306 chronic cyclosporine nephrotox. 637 addictive behavior 19
959
INDEX
age 17 MDR-glycoprotein transport 60 star fruit intoxication 902

co-existing chronic diseases 18 colic continuous medium perfusion
definition 3 lead nephropathy 774 cell culture 239
environmental exposure 15 sulfadiazine 355 convoluted tubule
gender 16 collagen bundles amphotericin B therapy 327
genetic susceptibility 14 gadolinium 711 copper
incidence 3, 4 collagens cephalosporins 297
individual risk factors 20–21 collagen III 644 in renal failure 888–889
mechanisms 6–10 collecting duct mercury exposure 821
monitoring of renal function 12–13 cell culture 226 smelters
nutrition 17 lithium transport 727 cadmium-induced renal effects
occupational exposure 15 NSAIDs 422 786, 788
outcome 3, 5 colocalization sulphate 837, 865–866
populations at risk 13–20 aminoglycoside transport 272 transporter 231, 238
race 16 colony-stimulating factor coproporphyrins
specific drugs 10–12 knockout mouse model 176 lead nephropathy 774
cloaxicillin 296 coma cortex
clodronate 547 cocaine abuse 605 aminoglycosides 268, 270
clinical toxicity 554 drugs overdose 609 cortical atrophy
pharmacokinetics 549, 551 heroin abuse 604 analgesic nephropathy 404
preclinical toxicity 553 compensatory responses corticosteroids 431
clofibrate animal models 176 dosing in renal failure 942
drug metabolism studies 63 complement factor B mitomycin therapy 523
clonidine knockout mouse model 177 proton pump inhibitors 574
organic cation transport 57, 58, 63 complement regulatory protein Cortinarius 764
Clostridium knockout mouse model 177 orellanus 763
vancomycin 281 complement system cosmetics
clusterin chronic cyclosporine nephrotox. 635 lead nephropathy 776
urinary biomarkers 116 compound A cost-benefit
clyclosporine sevoflurane degradation 540 aminoglycoside dosing 277
and pentamidine 364 concentrating defect, urinary cotransporters
CO2 absorption 540 lithium treatment 732 phosphate 580
coagulopathy conditional gene knockout cotrimoxazole 356
amphetamines 867 knockout mouse model 177 COX-2 inhibitors
cobalt chloride 302, 305, 310 confounding diuretics 496
cobra venom 190 pharmacovigilance 89 crack abuse 605
cocaine abuse 605–607, 867 congeners of gentamicin 280 crank
and heroin abuse 600 congestive heart failure amphetamines 866
clinical relevance 19 ACE inhibitors 486 Cre/LoxP 177
cocci 297, 298 beta-lactams 313 creatinine clearance
Cockroft and Gault formula 99 cocaine abuse 605 trimethoprim-sulfamathoxazole 357
codeine 596, 603 mercury-containing treatment 812, urinary biomarkers 98
analgesic nephropathy 403 817 Cremophor
colchicine NSAIDs 424, 427, 435, 439 acute cyclosporine nephrotox. 624
allopurinol nephropathy 471 connective tissue growth factor Cre recombinase 177
and cyclosporine 635 cell culture 231 crescentic glomerulonephritis 133
heroin abuse 601 consciousness disturbed paraphenylene diamine 875
960
INDEX
silicon containing compounds 832, namic injury 619–624 cyst formation

835 mesangial cells 624 lithium treatment 731
cresols 862 nitric oxide 620–621 cystinuria
Croatia oxidative stress 623 D-penicillamine therapy 465
Balkan nephropathy 844–846 prostaglandins 621–622 cystoscopy 406
Slavonski Brod, Balkan nephropathy renin-angiotensin system 619–620 cytochrome C
844 sympathetic system 622–623 aminoglycoside nephrotoxicity 276
cryptococcosis and aminoglycosides 269 cell culture 233
amphotericin B therapy 324 and amphotericin B therapy 326, 343 cellular mechanisms 159
crystalluria and beta-lactams 313 cytochrome P-450
acute kidney injury 32 and ciprofloxacin 370 acute cyclosporine nephrotox. 627
acyclovir 384 and lithium 740 anesthetic agents 538
animal model of nephrotoxic injury and trimethoprim-sulfamathoxazole aristolochic acid nephropathy 761
180 358 beta-lactams 302, 309
ciprofloxacin 370 animal models 175, 203 cell culture 224, 239
foscarnet 387 Balkan nephropathy 848, 849 drug clearance 914
in acute kidney injury 9 blood levels 626 drug metabolism studies 63
indinavir 390 cell culture 230–232 in acute kidney injury 8
sulfadiazine 355 cellular mechanisms 157, 161 proton pump inhibitors 568
sulfonamides 353 chronic nephrotoxicity 630–645 cytokeratin
temafloxacin 371 autoimmune diseases 640–643 cell culture 225
crystal metamphetamine 866 bone marrow transplantation 640 cytokines 683
curcumin clinical aspects 636–643 aminoglycoside nephrotoxicity 276
acute cyclosporine nephrotox. 623 CSA-free immunosuppresion 645 cell culture 225, 236
cyanidanol E early recognize 644 proton pump inhibitors 572
cephalosporin nephrotoxicity 310 management 644–646 urinary biomarkers 110–112
cyclooxygenase (COX) 420, 435 mechanism of injury 631–636 cytomegalovirus
acute cyclosporine nephrotox. 621, other solid organ transplantation acyclovir 384
623 637–639 cidofovir 385
analgesic nephropathy 404 primary renal disease 643–644 foscarnet 386
COX inhibition 422 renal transplantation 636–637 ganciclovir 385
COX inhibition:microcirculation working hypothesis 636 valacyclovir 385
model 185 cyclosporine G 628 cytosegrosomes
glomerular expression 422 heroin nephropathy 599 aminoglycoside nephrotoxicity 273
nephrotoxic injury 205 hydronephrotic kidney 190 cytosine monophosphate 385
cyclophosphamide 512, 517 immune response 138 cytotoxicity
D-penicillamine nephropathy 466 MDR-glycoprotein transport 60 acute cyclosporine nephrotox. 624
cyclosporine 619–645 microcirculation model 185
acute kidney injury 31 microemulsion 628 D
acute nephrotoxicity 619–630 NSAIDs 445 D-penicillamine 465–469
clinical aspects 625–626 pharmacological aspects 74 autoimmunity 141
cremophor 624 proton pump inhibitors 570 Goodpasture’s-like syndrome
endothelin 620 SDZ IMM-125 628 466–467
management 626–630 urinary biomarkers 115 histopathology 465
mechanisms of tubular injury Cyr61 183 lupus erythematosus 467
624–625 cystatin C 106 mercury excretion 821
mechanisms of vascular/hemody- monitoring of renal function 12 monitoring of nephropathy 468–469
961
INDEX
pathogenesis of nephropathy 467–468 heroin abuse 600 diltiazem

prediction of nephropathy 468–469 lithium treatment 728, 733 and amphotericin B 331, 332
prognosis of nephropathy 465–466 diabetes mellitus dimercaprol 819
proteinuria 465 ACE inhibitors 490 chelation therapy in copper sulphate
renal vasculitis 467 gadolinium 709 toxicity 866
therapy of proteinuria 465–466 NSAIDs 427 dimercaptopropane-1 sulphonate 821
daclizumab 692 organic solvents 830 dimercaptosuccinic acid 821
dapsone 361, 367–368 pancreas transplantation 640, 643 dimethylthiourea 182
daptomycin 284 radiocontrast agents 701, 703 dinitrophenol 305
deafness smoking 897 dioscorine 868
sodium bromate 865 diacetylbenzidine dioxane 828
decontamination organic solvents 831 diphenyl-phenylenediamine 310
poisoning 252 dialytic therapies for poisoning dipyridamol
dedifferentiation 251–264 radiocontrast agents 702
pharmacological aspects 78 diarrhea diquat 307, 837
defluorination ACE inhibitors 487 disopyramide
anesthetic agents 539 amphetamine 608 organic cation transport 56
degreasers 828, 829 cadmium-induced renal effects 787 disproportionality
dehydropeptidase diatomite pneumoconiosis 832 pharmacovigilance 88
acute cyclosporine nephrotox. 628 diatrizoate 204 distal nephron
delavirdine 389 diazepam 539 pharmacological aspects 76–77
delayed graft function acute kidney injury 609 distal tubule
acute cyclosporine nephrotox. 625, dichloroacetate animal models, tubular injury 184
626 and antiretroviral agents 389 disulfiram 297, 298
trimethoprim-sulfamathoxazole 358 dichlorodiphenyltrichloroethane diuretics 495–501
demyelinating disease (DDT) 836 anatomic lesions 500–501
polyradiculoneuropathy 643 dichlorophenoxyacetic acid 837 and ACE inhibitors 486, 487
dendritic cells 134 dichromate and allopurinol 472
deoxyguanosine 384 purgative, South Africa 861 and lithium 739, 742
dermatitis diclofenac 431 dosing in renal failure 930–931
allopurinol therapy 469 dicloxacillin 296 functional abnormalities 495–498
exfoliative 469 didanosine 387 functional lesions 500–501
dermatomyositis diethylene glycol 828 glomerular filtration 46
D-penicillamine therapy 465 diethylenetriaminepentaacetic acid hypokalemic nephropathy 500–501
desferrioxamine (DTPA) immune response 138
aminoglycoside nephrotoxicity 279 monitoring of renal function 12 interstitial nephritis 498–499
beta-lactams 308, 310 diflunisal loop 500, 739
desflurane 540 drug metabolism studies 63 mercury-containing treatment 817
desmin 225 difluoromethoxydifluoroacetic acid models of ischemia 199
desquamation 539 nephrocalcinosis 499–500
aminoglycoside nephrotoxicity 274 digitalis 860 nephrolithiasis 499–500
dexfenfluramine digoxin NSAIDs 428
aristolochic acid nephropathy 759 pharmacokinetics in uremia 915 potassium-sparing 498
diabetes insipidus, nephrogenic tubular secretion 62 renal hemodynamics 495–498
cidofovir 386 dihydrofolate reductase renal parenchymal lesions 498–500
didanosine 389 antimetabolites 520 thiazides 496
foscarnet 387 dihydrothiazine 294 divalent metal transporter
962
INDEX
cell culture 238 neonatal aminoglycoside transport 272

diviners (Africa) 859 ACE inhibitors 488 endosomes 232, 234
DNA adducts endothelial cells 225, 226, 228, 239
aristolochic acid nephropathy 760 E cyclosporine nephrotoxicity 620
DNA damage echogenicity endothelin
cell culture 236 HIV nephropathy 601 acute cyclosporine nephrotox. 620,
DNA fragmentation ecstacy abuse 608 628
models of ischemia 200 ecstasy abuse animal model of septic injury 182
DNA polymerase amphetamines 866–867 animal models 203
foscarnet 386 edema chronic cyclosporine nephrotox. 634
DNA synthesis gadolinium 709, 712 hydronephrotic kidney 189
cell culture 229, 231, 232 HIV nephropathy 601 isolated perfused rat kidney 198
dopamine mercury exposure 818 knockout mouse model 178
and amphotericin B 332 NSAIDs 428, 431, 437 models of ischemia 202
hydronephrotic kidney 189 EDTA NSAIDs 436
organic cation transport 58 beta-lactams 308 radiocontrast agents 702, 707
radiocontrast agents 705 lead nephropathy 774 smoking 896, 897
dosage of drugs trimethoprim-sulfamathoxazole 357 tacrolimus nephrotox. 647
biologically effective dose 93 EEG epileptiform activity urinary biomarkers 115–116
in renal failure 913–944 star fruit intoxication 909 endothelium
urinary biomarkers 93 efavirenz 389 lead nephropathy 777
drug-induced risk eicosanoids endothelium-derived hyperpolarizing
pharmacovigilance 85 acute cyclosporine nephrotox. 621 factor
drug-induced thrombotic microangio- elanapril animal models 204
pathy pentamidine 364 isolated perfused rat kidney 198
in acute kidney injury 10 elderly patients endotoxin
drug abuse 595–616 NSAIDs 427, 435 aminoglycoside nephrotoxicity 276
drug classification elevated osmolal gap enflurane 539
mechanisms of acute kidney injury 9 alcohol ingestion 502 enoxacin 369
drug dosage in renal failure 913–944 enalapril 482–491 Enterobacteriaceae 296
absorption 915 acute cyclosporine nephrotox. 621 Enterococci 297, 298
dialysis 916–917 chronic cyclosporine nephrotox. 631 vancomycin 281
dosing regimens 916 drug metabolism studies 63 environmental exposure
elimination 916 tubular reabsorption 48 cadmium-induced renal effects 801
pharmacokinetics in uremia 914–916 enalaprilat 231 lead nephropathy 779
protein binding 915 encephalopathy enzymuria 107–110
therpeutic drug monitoring 916 amphotericin B therapy 339 anesthetic agents 540
volume of distribution 915 lead poisoning 774 cephalosporins 297
drug prescribing endocrine agents organic solvents 830
pharmacovigilance 89 dosing in renal failure 932–933 eosinophilia
drug safety endocytosis abacavir 388
urinary biomarkers 92 aminoglycoside transport 271 ACE inhibitors 482
DTPA cephalosporins 297 acyclovir 384
glomerular filtration rate measure- drug transport 48 allopurinol therapy 469, 470
ment endolymph beta-lactams 296
renal artery stenosis 485 aminoglycosides 270 ciprofloxacin 370
ductus arteriosus, patent endoplasmic reticulum immune response 132, 138, 145
963
INDEX
NSAIDs 431 erythropoietin cidofovir 386

proton pump inhibitors 572 gadolinium 712 didanosine 389
trimethoprim-sulfamathoxazole 358 Escherichia coli 297, 298 ifosfamide therapy 518
eosinophiluria esomeprazole 567 lead nephropathy 775
ACE inhibitors 482 etanercept 692 lithium treatment 741
ciprofloxacin 370 ethacrynic acid 496 paraquat 866
immune response 138 and lithium 739 tenofovir 389
indinavir 391 ethane 309 zidovudine 388
proton pump inhibitors 571 ethanol Fas ligand 229, 230, 232, 233
urinary biomarkers 96 anesthetic agents 539 feeding cycle
ephedrine ethers 828 cell culture 228, 239
pH-dependent reabsorption 47 ethoxy-coumarine-O-deethylase (7-) fenfluramine
epidemiology cephalosporins 303 aristolochic acid nephropathy 759
acute kidney injury 29–30 ethylenediamine tetraacetic acid: fenoldopam
epidermal growth factor See EDTA and amphotericin B 332
animal models, tubular injury 184 ethylene glycol 503, 828, 867–868 radiocontrast agents 705
cell culture 227, 237 oxalate 751 fenoprofen 426, 431, 432, 434
cellular mechanisms 163 treatment 503 ferritin
models of ischemia 200 etidronate 547 beta-lactams 308
epidermal necrosis clinical toxicity 554 heroin abuse 604
allopurinol therapy 469, 471 pharmacokinetics 551 fever
epidermal thickening etoposide 59 proton pump inhibitors 572
paraphenylene diamine 873 Europan Center for the Validation of fialuridine
EpiFlow 228, 239 Alternative Methods heptic failure 389
epigallocatechin cell culture 239 fibers
acute cyclosporine nephrotox. 623 European Dialysis and Transplant As- silicon containing compounds 834
epilepsy sociation (EDTA) fibrillarin 140
star fruit intoxication 903, 908 data of risk factors for progressive fibrinogen
epithelial-mesenchymal transition 231 renal failure 13 cocaine abuse 606
cell culture 231 everolimus 650 fibrinoid necrosis
epithelial cells exchange transfusion allopurinol therapy 470
acute cyclosporine nephrotox. 620, poisoning 256 amphetamines 867
624 exposure data fibroblasts
chronic cyclosporine nephrotox. 632, pharmacovigilance 87 chronic cyclosporine nephrotox. 632
634 extracellular fluid volume depletion HIV nephropathy 603
urinary biomarkers 96 acute cyclosporine nephrotox. 624 tacrolimus nephrotox. 649
eplerenone 498 extracellular matrix components fibrocyte-like spindle cells
Epstein-Barr virus cell culture 227, 228, 230, 231 gadolinium 711
acyclovir 384 fibronectin 801
cidofovir 385 F fibrosis 205
ergosterol F0-F1-ATPase Balkan nephropathy 848
amphotericin B binding 328, 336 cellular mechanisms 158 lithium treatment 731
ERK1/2 237 famotidine organic solvents 830
erythematosus tubular secretion 63 silicon containing compounds 832
paraphenylene diamine 873 Fanconi syndrome fibrous glass
erythrocytes aristolochic acid nephropathy 758 silicon containing compounds 834
isolated perfused rat kidney 197 cadmium-induced renal effects 790 fish consumption
964
INDEX
mercury exposure 812, 815 and aminoglycosides 269 analgesic nephropathy 406
fish oil and amphotericin B 332 D-penicillamine therapy 465
acute cyclosporine nephrotox. 622, and beta-lactams 313 gold salt therapy 460
627 and lithium 739 tract infections
flexoracin 371 cell culture 226 quinolones 368
flour glomerular filtration 46 gatifloxacin 369
lead poisoning 847 organic cation transport 61 gemcitabine 521–522
flow cytometry radiocontrast agents 705 gene polymorphisms
urinary biomarkers 97 fusion inhibitors 391 proton pump inhibitors 569
flucytosine FVB-TIE2/GFP mouse 194 genetics
and amphotericin B 332 fybrinolytic activity immune response 132, 143
fludarabine 692 tacrolimus nephrotox. 648 gentamicin 267–281
fluorescein 306 cell culture 225, 232–233
isothiocyanate inulin 183 G clusterin 116
fluoride gadolinium organic cation transport 56
anesthetic agents 539–542 chelates 712, 714 geophagia
fluorination cyclic gadolinium containing contrast lead nephropathy 776
anesthetic agents 538 agents 715 giant cells
fluoroquinolones 368, 369 hemodialysis 715 indinavir 391
flurbiprofen in renal failure 889 Globes
tubular secretion 62 nephrogenic systemic fibrosis amphetamines 866
focal segmental glomerulosclerosis 709–715 glomerular filtration rate
allopurinol therapy 470 differential diagnosis 711 aminoglycosides 270, 277
bisphosphonates 558 other risk factors 712 ciprofloxacin 369
chronic cyclosporine nephrotox. 644 pathogenesis 714 drug transport 46
gold salt therapy 460 physical therapy 714 gadolinium 708
heroin abuse 596 prevention 715 monitoring of renal function 13
organic solvents 831 treatment 714 NSAIDs 423, 435
urinary biomarkers 115 ulttraviolet light therapy 714 single nephron
folic acid 366 risk of acute kidney injury 709 diuretics 496
organic anion transport 54 transmetallation 714 trimethoprim-sulfamathoxazole 357
fomepizole 260, 503 gait urinary biomarkers 98–100
Food and Drug Administration (US) cadmium-induced renal effects 790 glomerular lesions
mercury-containing products 812, 813 lithium treatment 741 mercury exposure 819
formaldehyde gallnut 871 glomerulonephritis
alcohol ingestion 502 gamma-aminobutyric acid 5-aminosalicylic acid 409, 412
formic acid star fruit intoxication 908 crescentic 133
alcohol ingestion 502 gamma-globulins D-penicillamine therapy 466
foscarnet 386 urinary biomarkers 104 foscarnet 386
and cyclosporine 626, 627 gamma-lactams 314 organic solvents 829
and pentamidine 366 garlic silicon containing compounds 833
fungal infections 324 acute cyclosporine nephrotox. 623 urinary biomarkers 114
fungicides 836 gas chromatography glomerulopathy
Fungizone mercury determination 816 bevacizumab therapy 525
amphotericin B therapy 338 gastrointestinal agents chronic cyclosporine nephrotox. 643
furosemide 190, 496, 499, 500 dosing in renal failure 933 T-cell dependent 133, 138
and ACE inhibitors 482 gastrointestinal side effects glomerulosclerosis
965
INDEX
ACE inhibitors 490 ethylene glycol 867 gout

cell culture 230 glycols 828 allopurinol therapy 469
lithium treatment 731 glycolysis 231 diuretics 499
smoking 897 fluoride toxicity 540 dosing of agents in renal failure 937
zidovudine 388 glycoprotein lead nephropathy 773, 777
glomerulus ABC transporters 60–61 grain dust
pharmacological aspects 74–75 cell culture 231, 235, 238 silicon containing compounds 835
gluconeogenesis 309, 312 chronic cyclosporine nephrotox. 634 gram-negative bacteria
glucose drug clearance 914 quinolones 368
cell culture 227–233 organic cation transport 60 gram-positive bacteria
glucose (D-) uptake glycosaminoglycans 404 quinolones 368
beta-lactams 311 oxalate 753 granulocytopenia
glucuronic acid glycosuria gold salt therapy 460
ciprofloxacin 369 ACE inhibitors 483 granulomatous glomerulonephritis
glucuronidase anesthetic agents 540 gold salt therapy 460
pentamidine 364 Balkan nephropathy 852 green tea
glucuronide cidofovir 386 acute cyclosporine nephrotox. 623
beta-lactams 305 heroin abuse 600 growth factors
drug metabolism studies 63 lithium treatment 741 pharmacological aspects 79
tubular reabsorption 48 glyoxylate 750 guanidine
glucuronyl transferase ethylene glycol 867 organic cation transport 57
cell culture 224 glyphosphate-surfactant herbicide 837 gums, inflammation
glues gold mines 812 mercury exposure 812, 816
organic solvents 828, 829 gold salts 460–464
glutamyltransferase (gamma-) autoimmunity 140–143, 462 H
beta-lactams 304 histopathology of glomerular lesions H+/K+ ATPase
organic solvents 829 460–461 proton pump inhibitors 568
urinary biomarkers 108 histopathology of interstitial lesions hair
glutamyltranspeptidase (gamma-) 461 mercury exposure 815
cell culture 233, 238 immunosuppressive effects 462 hairdressing
glutathione monitoring of nephropathy 463–464 sodium bromate 865
acute cyclosporine nephrotox. 623 parenterally administered 460 hair waving
analgesic nephropathy 404 pathogenesis of nephropathy 461–463 sodium bromate 865
aspirin effect 434 pharmacological aspects 74 half-life
beta-lactams 305, 306 prediction of nephropathy 463–464 elimination of drugs 916
carbapenems 299 prevention of nephropathy 463–464 hallucinogenics 607
cell culture 224, 229, 235, 237, 238 prognosis 463 halogenated anesthetics 539
cephalosporins 303 therapy 463 halothane 539
peroxidase 183 gold thioglucose 460 Hantavirus
tacrolimus nephrotox. 648 Golgi apparatus ribavirin 391
glutathione-S-transferase (GST) aminoglycoside transport 272 hapten
anesthetic agents 540 cell culture 232 proton pump inhibitors 572
cell culture 224, 238 Goodpasture’s syndrome harmaline
urinary biomarkers 109 D-penicillamine therapy 465, 466 organic cation transport 57
glutethimide 609 organic solvents 829, 830 healers (Africa) 859
glycerol 828 paraphenylene diamine 876 heart transplantation
glycoaldehyde gossypol 202 acute cyclosporine nephrotox. 625
966
INDEX
chronic cyclosporine nephrotox. 637 mitomycin therapy 522 herpes viruses

tacrolimus nephrotox. 646, 649 tacrolimus nephrotox. 646 acyclovir 384
heat stock proteins 115 valacyclovir 385 allopurinol therapy 471
heavy metals hemolytic anemia cidofovir 385
chelation therapy 257 ACE inhibitors 482 penciclovir 385
hematoxylin-eosin staining gemcitabine therapy 521 hiccups
animal model of ischemic injury 179 immune response 138 star fruit intoxication 902
hematuria hemoperfusion high-molecular weight proteinuria
acyclovir 384 copper sulphate 866 urinary biomarkers 103–105
amphetamine 608 methotrexate therapy 521 histamine
aristolochic acid nephropathy 760 mushroom nephrotoxicity 764 organic cation transport 58
beta-lactams 296 paraquat 866 histidine 310
D-penicillamine therapy 465 poisoning 254 histiocytes
gold salt therapy 460 star fruit intoxication 906 indinavir 391
heroin abuse 598 Hemophilus influenzae 297, 298 histocompatibility
immune response 138 hemopoiesis proton pump inhibitors 572
NSAIDs 431 knockout mouse model 176 histology
pentamidine 363 hemorrhagic cystitis animal model, measurement of injury
proton pump inhibitors 571, 573 ifosfamide therapy 518 181
sulfadiazine 355 Henle, loop HIV infection
urinary tract tumors 406 amphotericin B therapy 327 amphotericin B therapy 324
heme oxidase lithium transport 727 heroin nephropathy 601–603
heroin abuse 604 henna 871 pentamidine 362
heme oxygenase Henoch-Schonlein purpura trimethoprim-sulfamathoxazole 358
chronic cyclosporine nephrotox. 635 cocaine abuse 606 HK-2 cell line 226, 229, 230, 231, 234,
hemodiaflitration hepatic disorders 235, 237
copper sulphate 866 fialuridine 389 hormone responsiveness 225, 239
hemodialysis hepatic steatosis HSP 70 231
Balkan nephropathy 853 zidovudine 388 human papillomavirus (HPV) 226
gadolinium 715 hepatitis B virus hyalinosis
mushroom nephrotoxicity 764 cell culture 236 chronic cyclosporine nephrotox. 630,
poisoning 254 penciclovir 385 642
star fruit intoxication 905 hepatitis C virus heroin abuse 598
trace metal disturbances 885–886 amphetamines 608 tacrolimus nephrotox. 649
vancomycin 284 cell culture 236 hyaluronic acid
hemodynamic changes heroin abuse 597 oxalate 754
acute cyclosporine nephrotox. 619 ribavirin 391 hydralazine 139
hemoglobin hepatocyte growth factor hydration
cell culture 237 aristolochic acid nephropathy 762 cisplatin therapy 514
hemoglobulinuria chronic cyclosporine nephrotox. 635 hydrochlorothiazide 498, 499
sulfonamides 353 hepatorenal syndrome organic cation transport 61
hemolysis mushroom nephrotoxicity 763 hydrocortisone 227
sodium bromate 865 herbal therapies 757–762 hydrogen peroxide
hemolytic-uremic syndrome Africa 859 acute cyclosporine nephrotox. 623
acute cyclosporine nephrotox. 625, herbicides 836 aminoglycoside nephrotoxicity 276
626 heroin nephropathy 598–604 hydronephrosis
heroin abuse 596 clinical relevance 19 5-aminosalicylic acid 412
967
INDEX
animal models 187, 194 acute cyclosporine nephrotox. 619 pentamidine 366
aristolochic acid nephropathy 759 hyperpyrexia pesticides 836, 837
sulfadiazine 356 cocaine abuse 605, 606 phencyclidine abuse 607
hydroxybenzoate phencyclidine abuse 607 hypocalciuria
tubular reabsorption 48 hypersensitivity lithium treatment 737
hydroxyl allopurinol therapy 469 hypoglycemia
aminoglycoside nephrotoxicity 276 dapsone 367 pentamidine 366
hydroxynalidixic acid 368 immune response 132 hypoglycemic agents
hypercalcemia organic solvents 831 dosing in renal failure 932
aminoglycosides 269 proton pump inhibitors 572 hypokalemia
foscarnet 387 trimethoprim-sulfamathoxazole 357 alcohol abuse 609
phencyclidine abuse 607 hypertension aminoglycosides 269, 280
hypercalciuria amphetamine 608 amphotericin B therapy 326
lithium treatment 741 bevacizumab therapy 524 didanosine 387, 389
hypercellularity cocaine abuse 605, 606 diuretics 500
amphotericin B therapy 327 heroin abuse 598, 600 diuretics:chronic 501
hypercoagulable state lead nephropathy 773, 778 lithium treatment 733, 737
gadolinium 712 NSAID effect 435, 437 proton pump inhibitors 570
hyperechoic foci phencyclidine abuse 607 hypomagnesemia
sulfadiazine 356 renovascular 481 aminoglycosides 269, 280
hyperfiltration systemic 481 amphotericin B therapy 326, 343
diuretics 498 treatment by ACE inhibitors 481–494 chronic cyclosporine nephrotox. 635
hyperkalemia hypertonic saline cisplatin therapy 514
lithium treatment 737 cisplatin therapy 515 foscarnet 387
NSAIDs 427 hyperuricemia pentamidine 366
pentamidine 365 allopurinol therapy 469 tacrolimus nephrotox. 648
pyrimethamine 367 chronic cyclosporine nephrotox. 635 hyponatremia
tacrolimus nephrotox. 648 didanosine 388 amphetamines 867
trimethoprim-sulfamathoxazole 361 diuretics 499 cadmium-induced renal effects 792
hyperlipidemic agents phencyclidine abuse 607 proton pump inhibitors 569
dosing in renal failure 932–933 radiocontrast agents 701 trimethoprim-sulfamathoxazole 358
hypernatremia tacrolimus nephrotox. 648 hypophosphatemia
lithium treatment 742 hyperuricosuria cidofovir 386
hyperoxalemia 751 allopurinol nephropathy 471 didanosine 389
hyperoxaluria 750–751 hyperviscosity syndrome foscarnet 387
enteric 751 D-penicillamine therapy 465 paraquat 866
primary 751 hypnotics 609 hypoproteinemia
hyperparathyroidism hypoalbuminemia glomerular filtration 46
lithium treatment 737 glomerular filtration 46 hypoprothrombinemia
hyperphosphatemia heroin abuse 600 cephalosporins 297, 300
acute phosphate nephropathy 580 sulfadiazine 355 hyporeninemic hypoaldosteronism
cadmium-induced renal effects 792 trimethoprim-sulfamathoxazole 359 NSAIDs 427
foscarnet 387 hypocalcemia trimethoprim-sulfamathoxazole 361
lanthanum treatment 887 cadmium-induced renal effects 792 hypotension
pesticides 836, 837 didanosine 387 amantadine 391
phencyclidine abuse 607 foscarnet 387 amphetamine 608
hyperplasia heroin abuse 604 cocaine abuse 605, 606
968
INDEX
heroin abuse 604 imipenem 295, 298, 301, 304 infiltrating cells
neonatal imipramine chronic cyclosporine nephrotox. 633
ACE inhibitors 488 organic cation transport 57 inflammation
radiocontrast agents 701 pH-dependent reabsorption 47 animal model of ischemic injury 179
hypothrombinemia immune response 132–154 inflammatory bowel disease
cephamycins 298 mechanisms 134–138 5-aminosalicylic acid 409
hypothyroidism nephropathies 138–139 knockout mouse model 176
lithium treatment 737, 741 immune system disregulation urinary biomarkers 114
hypouricemia proton pump inhibitors 572 infliximab 692
didanosine 389 immunocompromised patients influenza virus
hypovolemia amphotericin B therapy 324 amantadine and rimatadine 391
heroin abuse 604 immunofluorescence 229, 237 ribavirin 391
indinavir 390 congeners of gentamicin 280 insecticides 828, 836
hypoxia immunogenic proteins insulin
5-aminosalicylic acid 411 proton pump inhibitors 572 cell culture 227, 233
acute cyclosporine nephrotox. 623 immunoglobulins 133 endocytosis 48
cell culture 227, 232 IgE hydronephrotic kidney 189
cellular mechanisms 157 proton pump inhibitors 572 insulin-like growth factor I
models of ischemia 199 intravenous acute cyclosporine nephrotox. 624
radiocontrast agents 702 immunomodulators 693 amphotericin B therapy 329
urinary biomarkers 113–114 models of ischemia 200
I immunomodulators 683–698 integrins
ibandronate 548 anti-thymocyte globulin 693 urinary biomarkers 113
clinical toxicity 557 interferons 688–691 intensive care 29–42
pharmacokinetics 549 interleukins 686–688 intercellular adhesion molecule-1
ibuprofen 422, 434, 438 intravenous immunoglobulin 693 cell culture 225
tubular secretion 62 monoclonal antibodies 691–693 knockout mouse model 177
ICAM: See intercellular adhesion pathogenesis 685–686 paraphenylene diamine 873
molecule-1 recombinant cytokines 686–691 urinary biomarkers 113
Ice immunosuppressive therapy interferons
amphetamines 866 cell culture 230 IFN-alpha 391
idiopathic pulmonary hemosiderosis D-penicillamine nephropathy 466 anticancer drugs 512, 523–524
organic solvents 829 gadolinium 712 immunomodulators 688–690
IFN: See interferons immunotherapy 523–524 IFN-beta
ifosfamide 512, 517–518 impila 863 immunomodulators 690
and beta-lactams 313 inclusion bodies IFN-gamma
IgA nephropathy mercury exposure 814 immune response 132, 133
organic solvents 829 indapamide 497, 498 immunomodulators 690–691
silicon containing compounds 832 indinavir 361, 390 pegylated IFN 690
urinary biomarkers 115 organic cation transport 57 type I
IL: See interleukins pharmacological aspects 75 cell culture 236–237
illicit drug abuse 595–616 indomethacin 205, 422, 426, 427, 430, urinary biomarkers 110
iloprost 438 interleukins
acute cyclosporine nephrotox. 622 and lithium 740 IL-12
imaging agents 699–724 beta-lactams 306 knockout mouse model 177
imidazole immunomodulators 687 IL-18
tubular secretion 63 radiocontrast agents 702 animal model, measurement of
969
INDEX
injury 183 allopurinol therapy 470 ACE inhibitors 485

IL-2 aristolochic acid nephropathy 758, acute cyclosporine nephrotox. 626
anticancer therapy 512, 523 762 aminoglycoside transport 272
immunomodulators 686–688 beta-lactams 296 analgesic nephropathy 404
IL-4 chronic 731, 733 animal models 178, 198
knockout mouse model 177 D-penicillamine therapy 467 cellular mechanisms 157
IL-6 diuretics 498–499 chronic cyclosporine nephrotox. 631,
knockout mouse model 177 foscarnet 386 636
IL-6:tacrolimus nephrotox. 649 gold salt therapy 461 NSAIDs 424
IL-8 immune response 138 radiocontrast agents 702, 706
urinary biomarkers 111 in acute kidney injury 8 rapamycin inhibitors 650
immune response 132–133 lead nephropathy 773 ischemic myopathy
interleukin-1 receptor NSAIDs 424, 431 analgesic nephropathy 406
knockout mouse model 177 organic solvents 830 animal models 176
proton pump inhibitors 572 silicon containing compounds 833 isepamicin 267
urinary biomarkers 110–112 intractable hiccups isethionate
interstitial fibrosis star fruit intoxication 902 pentamidine 363
analgesic nephropathy 404 intranuclear inclusion bodies isocaloric diet 438
aristolochic acid nephropathy 758 lead nephropathy 775 isoflurane 539
Balkan nephropathy 848, 849, 851 intravital two-photon microscopy isolated perfused mouse kidney
cell culture 230, 231 microcirculation model 193 animal models 194
chronic cyclosporine nephrotox. 630 inulin clearance isolated perfused rat kidney
drug abuse 867 animal model, measurement of injury animal models 194, 205
gold salt therapy 461 182 drug transport studies 45
tacrolimus nephrotox. 650 GFR measurement 436 isolated renal microvessels
zidovudine 388 pyrimethamine 367 microcirculation model 190
interstitial granulomas trimethoprim-sulfamathoxazole 361 isoniazid 539
ACE inhibitors 482 in vitro models 224–250 isopropanol 502
interstitial inflammation juxtamedullary nephron 186, 194 isopropyl alcohol 502
cell culture 229 inyanga 860 isoproterenol
HIV nephropathy 602 iodohippurate drug metabolism studies 63
interstitial nephritis renal artery stenosis 485 itai-itai disease
5-aminosalicylic acid 409 iohexol and Balkan nephropathy 847
abacavir 389 monitoring of renal function 12 cadmium-induced renal effects 790
acute 431, 606, 608 iothalamate
ACE inhibitors 481 GFR measurement 436 J
diuretics 498 monitoring of renal function 12 Jeyes fluid 862
granulomas 9 renal artery stenosis 485 juxtaglomerular apparatus
interleukin-2 therapy 523 iron arterioles
piromidic acid 370 chelation therapy 257 chronic cyclosporine nephrotox.
sulfadiazine 356 gadolinium 714 632
sulfonamides 353 in renal failure 889 microcirculation model 193
trimethoprim-sulfamathoxazole irregular gout
358, 359 lead nephropathy 778 K
acute kidney injury 32 irritation kallikrein-kinin system
acyclovir 384 mercury exposure 815 ACE inhibitors 483
allergic 431 ischemia acute cyclosporine nephrotox. 623
970
INDEX
cadmium-induced renal effects 801 lazaroids 190 acute cyclosporine nephrotox. 623
ketoconazole acute cyclosporine nephrotox. 623 aminoglycoside nephrotoxicity 279
and amphotericin B 329 LDH release 229, 230, 232, 233, 236 lipopolysaccharide
ketones 828 lead encephalopathy 774 knockout mouse model 176
ketorolac 426 lead nephropathy 773–784 lipoproteins
khat leaf 868 acute 775 amphotericin B formulations 336
kidney dysfunction Asian folk remedies 776 liposomal clodronate 179
gadolinium 709 Australia 776 lipoxygenase 420
kidney injury molecule 183 biomarkers of lead absorption lisinopril 438, 488
kidney injury molecule-1 774–775 acute cyclosporine nephrotox. 621
urinary biomarkers 114 causality and environmental exposure lithium 725–748
kidney specific gene targeting 779–780 and ACE inhibitors 487
knockout mouse model 177 chelation therapy 775, 780 aquaporin 729–731
kininase II chronic 775–777 clearance
angiotensin converting enzyme 483 clinical relevance 15 urinary biomarkers 101
kininogen D-penicillamine therapy 465 clinical side-effects 741
acute cyclosporine nephrotox. 624 Fanconi syndrome 775 distal nephron acidification 734
Klebsiella pneumoniae 297 gout 777–778 drug interactions 739–740
Kosovo hypertension 778 effect on water transport 728–731
Balkan nephropathy 844–846 lead workers 775, 778 histological findings 731–732
low level exposure 778–779 management of intoxication 742–743
L moonshine drinkers 775, 776 overdose 742
L-NAME plumbism 776 poisoning 258
acute cyclosporine nephrotox. 621 statistical analysis 779 polyuria 732–734
chronic cyclosporine nephrotox. 634 treatment 780–781 transport along the nephron 726–728
tacrolimus nephrotox. 648 lead poisoning 773 liver disorders
lactate Balkan nephropathy 847, 848 NSAIDs 424
organic anion transport 52 symptomatic 773, 775, 776, 778, 780 zidovudine 388
lactate dehydrogenase 108 leishmaniasis liver transplantation
beta-lactams 302 pentamidine 362 acute cyclosporine nephrotox. 626
mercury exposure 816 leucine aminopeptidase chronic cyclosporine nephrotox. 639
lactic acidosis mercury exposure 816 tacrolimus nephrotox. 646, 649
fialuridine 389 organic solvents 829 LLC-PK1 cell line 225–239
zidovudine 388 leukemia lomefloxacin 371
lactose 597 aminoglycoside nephrotoxicity 269 lomustine 519
lamivudine 387 leukocytosis Looser’s zones in bone
lansoprazole 567 phencyclidine abuse 607 cadmium-induced renal effects 790
lanthanum leukotrienes 432 lopinavir 390
in renal failure 887 acute cyclosporine nephrotox. 621 loracarbef 295, 298
Lareb levofloxacin losartan
Netherlands Pharmacovigilance organic cation transport 58 acute cyclosporine nephrotox. 619
Centre 88 Lindane 836, 837 chronic cyclosporine nephrotox. 631,
latamoxef 295, 298, 304, 314 linezolid 284 646
Lawasonia alba (henna) 871 lipid peroxidation lovastatin 190
laxatives cell culture 229, 237 low-molecular weight proteinuria
aloe capensis 864 lipocalins 105 Balkan nephropathy 850
phosphate nephropathy 580 lipoic acid urinary biomarkers 105–107
971
INDEX
low molecular weight proteins depletion vancomycin 284

aristolochic acid nephropathy 758 amphotericin B therapy 326 mental confusion
lung/heart transplantation Magnolia officinalis 758 star fruit intoxication 903
chronic cyclosporine nephrotox. 639 malaria meperidine 596
tacrolimus nephrotox. 646 Balkan nephropathy 845 pharmacokinetics in uremia 916
lung cancer malondialdehyde 309, 873 meprin-1-alpha inhibitor
cadmium-induced renal effects 788 acute cyclosporine nephrotox. 623 animal model of septic injury 182
lupus-like syndrome mammalian cells 226, 233 mercury 811–826
D-penicillamine therapy 465 manic-depressive disorders adverse renal effects 818–819
lupus erythematosus lithium treatment 725 animal models 204
D-penicillamine therapy 467 mannitol 202, 497 autoimmunity 140–143
paraphenylene diamine 876 and amphotericin B 332 biomarkers 816
silicon containing compounds 832 beta-lactams 310 brain toxicity 815
lupus nephritis cisplatin therapy 515 cell culture 235
NSAIDs 427 heroin abuse 604 cellular mechanisms 157
urinary biomarkers 115 radiocontrast agents 704 D-penicillamine therapy 465
lycopene marijuana abuse 609 dietary exposure 812
acute cyclosporine nephrotox. 623 mast cell activation 141 exposure 812–813
lymphocyte-depleting agents matrix composition general human toxicity 816–817
tacrolimus nephrotox. 648 chronic cyclosporine nephrotox. 636 history of human use 811
lymphotoxin 132 matrix degrading proteins immune response 135
lysosomes tacrolimus nephrotox. 650 immunotoxicity 817–818
aminoglycoside nephrotoxicity 273 MDCK cell line 226–240 inorganic mercury 812, 814, 817, 818
aminoglycoside transport 272 MDR transporters 60–61 mercury vapor toxicity 814, 816, 818
cadmium uptake 787 medicinal herbs 757 mines 813
cell culture 233 medulla nephrotoxicity 818–821
endocytosis 48 interstitial cells 422 ointments 812
proteins mefenamic acid 434 organic mercury 812, 814, 817, 819
cadmium-induced renal effects 790 megalin physical and chemical properties 811
aminoglycoside transport 271 poisoning 817, 820
M knockout mouse model 178 Africa 865
macrolides melatonin Kenya 864
dosing in renal failure 921–922 acute cyclosporine nephrotox. 623 production 812
macrophages aminoglycoside nephrotoxicity 279 toxicokinetics 813–814
acute cyclosporine nephrotox. 620, membranoproliferative glomerulo- treatment 821
621 nephritis urinary enzymes 816
animal model of ischemic injury 179 heroin abuse 596, 597 meropenem 295, 299, 301
chronic cyclosporine nephrotox. 632, urinary biomarkers 115 mesangial cells
633 membranous glomerulonephritis acute cyclosporine nephrotox. 620,
proton pump inhibitors 572 ACE inhibitors 481 621, 624
silicon containing compounds 835 auranofin therapy 464 cell culture 225, 230–233
tacrolimus nephrotox. 648 D-penicillamine therapy 465 tacrolimus nephrotox. 649
macula densa gold salt therapy 460 mesangial proliferative glomerulo-
NSAIDs 422 heroin abuse 596 nephritis
magnesium mercury exposure 817, 819 D-penicillamine therapy 465
acute cyclosporine nephrotox. 624 NSAIDs 432 gold salt therapy 460
chronic cyclosporine nephrotox. 635 meningitis heroin abuse 596, 602
972
INDEX
organic solvents 831 allopurinol nephropathy 471 cellular mechanisms 157, 158–159
mesna metolazone 497, 499 cisplatin therapy 514
cyclophosphamide therapy 517 mezlocillin 296, 307, 313 myopathy 388
ifosfamide therapy 518 microalbuminuria pharmacological aspects 75
mesylate smoking 896 mitogen-activated protein kinase
pentamidine 364 urinary biomarkers 94, 103 animal models, tubular injury 184
metabolic acidosis microdensitometry cellular mechanisms 162
alcohol ingestion 502 bone density measurement 792 models of ischemia 201
hypokalemia 389 microglobulin mitomycin 512, 522–523
lithium treatment 736 alpha1 104 mofetil mycophenolate
metabolic agents cadmium-induced renal effects 790 and cyclosporine 625, 629
dosing in renal failure 932 urinary biomarkers 105 and tacrolimus 648
metabolic alkalosis alpha2 105 mofetil mycophenylate
diuretics 501 beta2 831 proton pump inhibitors 574
metabolomics 229 Balkan nephropathy 850 molecular parameters
metalloproteinase cadmium-induced renal effects 790 animal model, measurement of injury
chronic cyclosporine nephrotox. 633 mercury exposure 815, 821 183
tacrolimus nephrotox. 650 microperfusions monobactams 295, 299
metallothionein drug transport studies 49 monoclonal antibodies
cadmium uptake 786 microporous supports immunomodulators 691
cell culture 234 cell culture 227 monocyte chemoattractant protein 1
metamphetamine 866–867 microproteinuria (MCP-1)
clinical relevance 19 cadmium-induced renal effects 797, chronic cyclosporine nephrotox. 633
methacholine 202 801 monocytes
methadone 596, 603 micropuncture acute cyclosporine nephrotox. 620
pH-dependent reabsorption 47 drug transport studies 45, 49 animal model of ischemic injury 179
methamphetamine 608 lithium transport 726, 739 immune response 138
methanol microscopic pattern recognition silicon containing compounds 835
poisoning 259, 503 urinary biomarkers 97 mononuclear cells
methemoglobinemia microvessels chronic cyclosporine nephrotox. 633
paraphenylene diamine 873 models of renal microcirculation 190 trimethoprim-sulfamathoxazole 358
methicillin 296 mills moonshine drinkers
proton pump inhibitors 573 lead poisoning 847 lead nephropathy 775
resistant Staphylococcus aureus mineral wool Morocco
vancomycin 281 silicon containing compounds 834 paraphenylene diamine 871
methimazole 314 miners 832 morphine 596, 597
aminoglycoside nephrotoxicity 279 minimal change glomerulonephritis drug metabolism studies 63
methotrexate 512, 520 chronic cyclosporine nephrotox. 643 organic cation transport 56
organic anion transport 54 D-penicillamine therapy 465 pharmacokinetics in uremia 916
pH-dependent reabsorption 47 gold salt therapy 460 tubular reabsorption 48
methoxyflurane 538 heroin abuse 596, 602 mouse kidney
methylene blue 202 NSAIDs 431 animal models 197
methylenedioxymethamphetamine 608 minoxidil 485, 487 moxalactam 295, 298
methylnicotinamide (N1) misoprostol moxifloxacin 369
drug metabolism studies 63 acute cyclosporine nephrotox. 622 MRP transporters 59–60
organic cation transport 55–59 mitochondrial disorders MRSA
methylprednisolone aminoglycoside nephrotoxicity 274 vancomycin 281
973
INDEX
MTT assay 229, 230, 235 myosin necrotizing arteritis

mucocutaneous reactions cell culture 225 sulfonamides 353
D-penicillamine therapy 467 necrotizing vasculitis
mucoproteins N amphetamines 867
cadmium-induced renal effects 791 N-acetyl-benzo-quinoneimine 434 cocaine abuse 606
multidrug resistance transporters N-acetyl-beta-D-glucosaminidase nelfinavir 361, 390
59–60 amphotericin B therapy 338 organic cation transport 57
in acute kidney injury 7 anesthetic agents 540 neomycin 267
multidrug transporters 60–61 beta-lactams 304 neonates
beta-lactams 305 lead nephropathy 777 anesthetic agents 542
multiple myeloma mercury exposure 820, 821 nephrocalcinosis 579–594, 752–754
NSAIDs 427 organic solvents 829 amphotericin B therapy 327
paraphenylene diamine 876 silicon containing compounds 829, calcium phosphate deposition 582
radiocontrast agents 701 835 diuretics 499–500
muscle actin 225, 231 urinary biomarkers 108–109 resolution 500
mushroom nephrotoxicity 763–765 N-acetylcysteine nephrogenic systemic fibrosis
mutation acute cyclosporine nephrotox. 623 gadolinium 709
aristolochic acid nephropathy 761 aminoglycoside nephrotoxicity 279 nephrolithiasis 752–754
myalgia Na+-dependent glucose transporter diuretics 499–500
amphetamine 608 233 uric acid 499
heroin abuse 604 Na+/Ca2+ exchanger indinavir 390
myasthenia gravis knockout mouse model 177 nelfinavir 391
chronic cyclosporine nephrotox. 643 Na+/H+ exchanger isoform 3 (NHE3) nephrotic syndrome
D-penicillamine therapy 465 117 ACE inhibitors 481, 490
mycosis infection 324 Na+/Li+ countertransporter (SLC) 726 acute kidney injury 32
mycotoxins Na+K+2Cl- cotransporter inhibitors autoimmunity 144
Balkan nephropathy 847, 848 190 glomerular filtration 46
cell culture 235 Na-K-ATPase gold salt therapy 460
myeloid bodies animal model of ischemic injury 179 heroin abuse 596
aminoglycoside nephrotoxicity 274 beta-lactams 311 HIV nephropathy 601
myeloid differentiation factor 88 cellular mechanisms 159 immune response 138
animal model of septic injury 182 fluoride toxicity 541 mercury exposure 817, 819
myeloperoxidase inhibition by aloe capensis 864 NSAIDs 424, 427
animal model of ischemic injury 179 organic anion transport 50 urinary biomarkers 104
silicon containing compounds 835 organic cation transport 56 zidovudine 388
myocardial infarction 439 nalidixic acid 368 netilmicin 267
cocaine abuse 605 naproxen 422, 436, 438 neurologic agents
myoclonic twitching narcotic antagonists dosing in renal failure 934–935
lithium treatment 741 dosing in renal failure 926 neuropathy
myoglobinuria narcotics lithium treatment 741
amphetamines 867 dosing in renal failure 926 peripheral 388
cell culture 237 necrosis neurotoxicity
heroin abuse 604 aminoglycoside nephrotoxicity 274 star fruit 902–904, 907–910
pentamidine 363 animal model of ischemic injury 178 neurotransmitters
phencyclidine abuse 608 cell culture 225, 230, 232 acute cyclosporine nephrotox. 622
myopathy cellular mechanisms 156 neutral endopeptidase
zidovudine 388 proximal convoluted tubules 411 acute cyclosporine nephrotox. 623
974
INDEX
enzymuria nitrosoureas 518–520 clinical relevance 17

aristolochic acid nephropathy 758 nocturia
neutron activation analysis lithium treatment 732 O
mercury determination 816 non-Hodgkin’s lymphoma obstructive nephropathy
neutrophils paraphenylene diamine 876 and Balkan nephropathy 853
acute cyclosporine nephrotox. 621 non-steroidal anti-inflammatory drugs obstructive uropathy
animal model of ischemic injury 179 419 methotrexate therapy 521
proton pump inhibitors 572 acute kidney injury 30–31 occupational exposure
silicon containing compounds 835 and ACE inhibitors 488 Balkan nephropathy 848
nevirapine 389 and adefovir 388 cadmium-induced renal effects 786,
New Zealand and ciprofloxacin 370 797
proton pump inhibitors 571 and cyclosporine 626, 627 lead nephropathy 773
NF-kappaB and lithium 740 mercury 813, 818, 820
tacrolimus nephrotox. 649 animal models 175 silicon containing compounds 832
NGAL 183 clinical relevance 11 ochratoxin
NHANES survey COX-2 inhibitors aristolochic acid nephropathy 760
lead nephropathy 778 diuretics 496 Balkan nephropathy 846, 847
nicotinate COX-2 inhibitors, renal effects 435, ochratoxin A
tubular reabsorption 48 436 cell culture 235
nifedipine cyclooxygenase isoforms 422 ocular lesions
acute cyclosporine nephrotox. 621 dosing in renal failure 937–938 allopurinol therapy 469
and amphotericin B 332 drug metabolism studies 63 off-label 89
chronic cyclosporine nephrotox. 646 immune response 138 ofloxacin 370, 371
tubular secretion 62 immunomodulators 687 OK cell line 225–226, 231–239
Nigella sativa mechanism of action 422 OKT3 nephrotoxicity
acute cyclosporine nephrotox. 623 microcirculation model 185 immunomodulators 685, 691
nitric oxide 430 organic anion transport 54 oligohydramnios
acute cyclosporine nephrotox. 620, prostaglandin analogs 444 ACE inhibitors 488
623 prostaglandins and renal function oliguria
animal models 204 420, 421 amphetamine 608
cell culture 232 renal syndromes 423, 424, 428, 430, ciprofloxacin 370
chronic cyclosporine nephrotox. 634 431, 432 heroin abuse 604
diuretics 496 tubular secretion 62 NSAIDs 431
hydronephrotic kidney 189 nonnarcotics sulfadiazine 355
inhibitors 199 dosing in renal failure 926 sulfonamides 353
isolated perfused rat kidney 198 noradrenaline omega-3 fatty acids
tacrolimus nephrotox. 647 and lithium 740 acute cyclosporine nephrotox. 627
nitric oxide synthase norepinephrine omeprazole 567
endothelial acute cyclosporine nephrotox. 622 oncosis
eNOS deficient mice 182 animal model of ischemic injury 178 pharmacological aspects 77
knockout mouse model 177 norfloxacin 369, 370 opioids 596–605
inducible NRK-52E 231 amyloidosis associated with heroin
animal model of septic injury 182 NSAIDs: See non-steroidal anti-inflam- abuse 599–601
knockout mouse model 177 matory drugs heroin nephropathy 598–604
nitrofurantoin nuclear respiratory factors HIV in heroin nephropathy 601–603
pharmacokinetics in uremia 916 cellular mechanisms 158 rhabdomyolysis 603–605
nitroprusside 485 nutritional state oral sodium phosphate 579–594
975
INDEX
orellanine 764 cadmium-induced renal effects 790, models of ischemia 198

organic acids 792 oxypurinol 470
aminoglycoside nephrotoxicity 275 osteopenia
organic anion transport 50–55 cadmium-induced renal effects 792, P
apical transporters 53 793 p21 Cyclin-dependent kinase inhibitor
beta-lactams 305 osteopontin 1A 229, 231, 238
cell culture 233, 235, 238 chronic cyclosporine nephrotox. 632, p53 tumor antigen
cephalosporin nephrotoxicity 312 633 aristolochic acid nephropathy 761
in acute kidney injury 7 knockout mouse model 177 cell culture 226, 229, 230, 232
molecular biology 52 oxalate 753, 754 cellular mechanisms 161
non-PAH transporters 54 osteoporosis p66shc adaptor protein 163
substrate requirements 52 cadmium-induced renal effects 790, paint
organic cation transport 55–59 792 removers 828
apical transporters 58 ototoxicity paints
basolateral transporter 57 aminoglycosides 267 organic solvents 829
beta-lactams 305 sodium bromate 865 palmitate 313
glycoprotein 60 vancomycin 283 pamidronate 548
in acute kidney injury 7 ouabain clinical toxicity 555
protein binding effects 61 and amphotericin B 332 histopathology 558
organic lead absorption 775 and beta-lactams 305 pharmacokinetics 551
organic solvents 828–831 overlap syndrome preclinical toxicity 553
aliphatic hydrocarbons 828, 829 silicon containing compounds 832 pancreas transplantation
aromatic hydrocarbons 828 ox-eye daisy 863 chronic cyclosporine nephrotox. 640
epidemiology 829–830 oxacillin 296 pancreatitis
experimental studies 831 oxalate 749–756 zidovudine 388
exposure 828–829 5-aminosalicylic acid 412 panipenem 295, 299
halogenated hydrocarbons 828, 829 calcium phosphate deposition 581 panthotenate
inhalation 828 cellular production 750 tubular reabsorption 48
mechanisms 830–831 end-product of metabolism 750 pantoprazole 567
mouth contact 828 ethylene glycol 867 para-aminohippurate (PAH)
oxygenated hydrocarbons 828, 829 in diet 750 beta-lactams 296
pathology 830–831 nephrocalcinosis 752–754 cephalosporins 298
skin exposure 828 nephrolithiasis 752–754 organic anion transport 50–55
orosomucoid oxalate/sulphate exchanger uptake in brush border membrane
mercury exposure 821 tubular secretion 49, 52 vesicles 311
osmolality star fruit intoxication 906 paranitroanaline 872
alcohol ingestion 502 toxicity 752 paraphenylene diamine 871–880
urinary biomarkers 100 oxalic acid 749–756 acute systemic toxicity 875
Osmoprep 581 oxazaphosphorines 517–518 cardiovascular system 876
osmotic nephrosis oxidative stress characteristics 872
acute kidney injury 33 acute cyclosporine nephrotox. 623 clinical presentation 873–875
in acute kidney injury 10 oxothiazolidine-4-carboxylate 307 dermatological manifestations 875
osteoarthritis oxygen diagnosis 876
NSAIDs 437 cell culture 224, 227, 239 experimental 873
osteocalcin consumption in organs 44 hepatotoxicity 876
cadmium-induced renal effects 793 pericellular 228, 238 nephrotoxicity 875
osteomalacia oxygen free radicals neurotoxicity 876
976
INDEX
ophthalmic effects 876 Peptococcus 296 phenmetrazine 608

pharmaco-toxicology 872–873 perchloroethylene phenobarbital 539
respiratory system 876 urinary biomarkers and cephalosporins 303
treatment 877 perfusion pressure pH-dependent reabsorption 47
paraquat 307, 308, 309, 866 hydronephrotic kidney 189 phenols 862
parathyroid hormone perilymph phenothiazines
cadmium-induced renal effects 794 aminoglycosides 270 drug dosing in renal failure 941
heroin abuse 604 peripheral neuropathy phenylbutazone 434
lithium treatment 737 lead poisoning 774 pH-dependent reabsorption 47
pars recta, proximal tubule peritoneal dialysis phenylmercuric nitrate 812
mercury exposure 818 poisoning 257 phenytoin 539
passive reabsorption star fruit intoxication 905 pH-dependent reabsorption 48
renal handling 46–48 trace metal disturbances 886 pharmacokinetics in uremia 915
pauci-ummune glomerulonephritis peroxidation, lipids phorbol myristate acetate 310
D-penicillamine therapy 466 carbapenems 299 phosphate 579–594
pediatric patients peroxisomes cadmium-induced renal effects 794
anesthetic agents 542 cellular mechanisms 157 calcium phosphorus product 588
pefloxacin 369, 370 knockout mouse model 178 cotransporters
PEG: See polyethylene glycol pertussis SLC34 gene family 580
peginterferon 690 lithium treatment 729 sodium-dependent 580
pemphigus vulgaris 460 pesticides 836–837 in the human body 579
penicillamide pethidine 877 phosphatidylinositol
chelation therapy in copper sulphate pH aminoglycosides 271
toxicity 866 fluoride elimination 541 endocytosis 48
penicillin 294, 306 urinary biomarkers 100–101 phosphatidylserine 230
and ciprofloxacin 369 phagocytic 225 phosphaturia
and trimethoprim-sulfamathoxazole pharmacoepidemiology 88 heroin abuse 600
358 pharmacogenetics 89 lithium treatment 738
dosing in renal failure 922 pharmacokinetics Phospho-soda 580
glomerular filtration 46 in uremia 914, 915 phosphodiesterase 182, 728
immune response 139 pharmacologic-interaction concept inhibitors
pH-dependent reabsorption 47 proton pump inhibitors 572 dosing in renal failure 931
pentamidine 359, 362–366 pharmacological aspects 73–84 phosphokinase
and aminoglycosides 364 cellular injury 77–78 cocaine abuse 605, 606
and amphotericin 364 distal nephron 76–77 phencyclidine abuse 607
and cyclosporine 364 glomerulus 74–75 phospholipase
and foscarnet 366 proximal tubule 75–76 animal model of ischemic injury 179
antimonial salt 364 regeneration 78–79 prostaglandins 421
isethionate 363 renal repair 78 phospholipids
mesylate 364 pharmacovigilance 85–90 aminoglycosides 270, 275
pentane 309 methodology 87–89 photographic developers
pentazocine 596, 597, 600 phenacetin paraphenylene diamine 872
pentoxiphylline analgesic nephropathy 404, 408 piddosome 161
and amphotericin B 330, 332 drug metabolism studies 63 pilocarpine
animal model of septic injury 182 urinary tract tumors 406 tubular secretion 63
peptide transporters phencyclidine abuse 607–608 Pink disease (acrodynia) 816, 820
in acute kidney injury 7 pH-dependent reabsorption 47 pinocytosis
977
INDEX
cadmium uptake 787 252 allopurinol nephropathy 470, 471

endocytosis 48 dialytic therapies 251–264 and abacavir 388
pioglitazone ethylene glycol 260 and cyclosporine 635
chronic cyclosporine nephrotox. 635 exchange blood transfusion 256 D-penicillamine nephropathy 467
piperacillin 313, 314 hemodialysis 254 pregnancy
and aminoglycosides 269 hemoperfusion 254 lithium treatment 741
pirfenidone peritoneal dialysis 257 premature ageing
chronic cyclosporine nephrotox. 635 plasmapheresis 256 analgesic nephropathy 406
tacrolimus nephrotox. 649 poly(ADP-ribose) polymerase-1 prepared mind
piromidic acid 370 knockout mouse model 177 pharmacovigilance 89
piroxicam 424, 426, 428 polyamines prerenal azotemia
planar cell surface area 230, 232 aminoglycoside nephrotoxicity 279 sulfonamides 497
plasma exchange: See plasmapheresis polyangitis prescription event monitoring
plasmapheresis silicon containing compounds 835 pharmacovigilance 88
D-penicillamine therapy 466 polyarteritis nodosa primary cell culture 225, 228, 238
mitomycin therapy 523 amphetamine 608 drug transport studies 45
mushroom nephrotoxicity 764 polycarbonate 227 primary renal disease
poisoning 256 polychondritis chronic cyclosporine nephrotox. 643
plasmid-mediated AmpC enzymes 295 chronic cyclosporine nephrotox. 643 pro-fibrotic changes
plasminogen activator inhibitor 1 polyclonal activation of B-cells 137 chronic cyclosporine nephrotox. 633
chronic cyclosporine nephrotox. 634 polyene antibiotics proapoptotic protein
platelet-endothelial cell adhesion amphotericin B 324 knockout mouse model 177
molecule 1 polyene macrolide 233 probenecid 305, 310, 367
cell culture 225 polyethylene glycol and adefovir 388
platelet activating factor purgatives 580 and cephalosporins 297
acute cyclosporine nephrotox. 623 polymyositis and cidofovir 386
platelets D-penicillamine therapy 465 organic anion transport 52
thromboxane synthesis 435 polyphenol organic cation transport 61
platinum acute cyclosporine nephrotox. 623 pH-dependent reabsorption 48
tubular secretion 62 tacrolimus nephrotox. 649 probucol
pleurisy polyuria aminoglycoside nephrotoxicity 279
D-penicillamine therapy 467 lithium treatment 728, 733 procainamide 139
Pneumocystis carinii 356 porphyrin 307 organic cation transport 55, 56, 57
pneumonia lead nephropathy 774 tubular secretion 62
pentamidine 362 mercury exposure 819 prokaryotic ribosomes
trimethoprim-sulfamathoxazole 358, post-antibiotic effect aminoglycoside nephrotoxicity 276
359 aminoglycosides 268, 278 proliferation
pneumonitis post-mortem kidneys pharmacological aspects 78
allopurinol therapy 470 models of ischemia 200 propanol 502
gold salt therapy 460 potassium propofenone
mercury exposure 812, 816 depletion 326 tubular secretion 62
podocalyxin 225 NSAIDs 427, 428 prostacyclin 435
podocytes 134, 143 potassium-sparing diuretics 498 acute cyclosporine nephrotox. 621
experimental morphine injections 597 pottery workers 832 prostaglandins 420, 423
poisoning predictomics 229 2,3-dinor-6-keto PGF1alpha 435
chelation therapy 257 prednisone 6-keto-PGF1alpha 427, 429, 436
criteria for extracorporeal removal after ACE inhibitors 482 tacrolimus nephrotox. 647
978
INDEX
acute cyclosporine nephrotox. 621 immune response 138 mercury-containing treatment 812
analgesic nephropathy 404 interferon therapy 524 psychiatric manifestations
animal models 204 mercury exposure 815, 818, 819 analgesic nephropathy 406
inhibition of synthesis 199 NSAIDs 431 psychiatric symptoms
vasoconstriction 488 organic solvents 830 mercury exposure 812, 816
misoprostal 444 proton pump inhibitors 571 psychosis
PGE2 427, 429, 430, 436 rapamycin inhibitors 650 lithium treatment 725
acute cyclosporine nephrotox. 621 smoking 896 psychosomatic complaints
hydronephrotic kidney 189 T-cell dependent 134 Africa 860
PGI2 430 urinary biomarkers 101–107 psychotropic drugs 734
acute cyclosporine nephrotox. 621 proteoglycans 404 and analgesics 406
synthetase proteomics 229 Psylocybe genus 764
aristolochic acid nephropathy 761 Proteus mirabilis 297 pulmonary fibrosis
vasodilation 483 prothrombotic state 435 paraquat 866
prostanoid receptors 420 proton pump inhibitors 567–578 purgatives 580–586
prostate cancer acute interstitial nephritis 571–575 OsmoPrep 581
cadmium-induced renal effects 788 bioavailability 568 Phospho-soda 580
prosthetic devices hyponatremia 569–570 Visicol 581
amphotericin B therapy 324 immune response 138 purinoceptor agonists
proteinase 3 implications for transplantation microcirculation model 187
silicon containing compounds 835 570–571 pyelography 406
protein binding mechanism of action 568 pyelonephritis
organic cation transport 61 pharmacogenetics 569 5-aminosalicylic acid 412
protein kinase C 190, 310 pharmacokinetics 568 and Balkan nephropathy 853
immune response 142 protooncogen pyrazinamide
proteinuria aristolochic acid nephropathy 761 tubular reabsorption 48
5-aminosalicylic acid 411 provinol pyrazolone
ACE inhibitors 482, 488, 490 acute cyclosporine nephrotox. 623 analgesic nephropathy 403, 409
acyclovir 384 proximal tubule pyrexia
amphetamine 608 aminoglycosides 270 amphotericin B therapy 339
anesthetic agents 540 animal model of ischemic injury 178 pyridoxine
aristolochic acid nephropathy 758 aristolochic acid nephropathy 758 tubular reabsorption 48
autoimmunity 144 cell culture 226, 230, 235 pyrimethamine 354, 356, 366
Balkan nephropathy 850, 852 cisplatin therapy 516 pyrimidine 366
beta-lactams 296 lithium transport 726 pyrogens 296
bevacizumab therapy 525 mercury exposure 818 pyrolizidine alkaloids 860
cadmium-induced renal effects 788 pharmacological aspects 75–76 pyrrolidin-2-one 314
cephalosporins 297 suspensions pyuria
cidofovir 386 drug transport studies 45 acyclovir 384
cocaine abuse 607 pruritus heroin abuse 598
D-penicillamine therapy 465 gadolinium 709 immune response 138
didanosine 389 Pseudomona aeruginosa 295 indinavir 390
diuretics 498 Pseudoxanthoma elasticum NSAIDs 431
foscarnet 386 MRP transporters 60 proton pump inhibitors 573
gold salt therapy 460 psoriasis
heroin abuse 598, 600 chronic cyclosporine nephrotox. 641 Q
HIV nephropathy 601, 602 fish oil supplementation 627 Queensland nephritis
979
INDEX
lead nephropathy 776 low osmolar 703 chronic cyclosporine nephrotox. 643
quercetin magnetic resonance 703 relaxin
acute cyclosporine nephrotox. 623 meta-analysis 703 acute cyclosporine nephrotox. 624
quinapril microcirculation model 185 renal artery clamping
tubular reabsorption 48 NO-blockade 703 animal model of ischemic injury 178
quinidine oliguric form 701 renal artery stenosis
organic cation transport 57, 58, 62 pathogenesis 701 ACE inhibitors 485
quinine 597 preexisting renal impairment 701 renal blood flow
organic cation transport 57 prevention/treatment 703 urinary biomarkers 100
pH-dependent reabsorption 47 renal blood flow 701 renal calcification
quinolones 368–371 risk factors 701 analgesic nephropathy 404, 408
dosing in renal failure 922–923 sodium depletion 702 renal calculi
immune response 138 vasoactive substances 702 saquinavir 391
quinondimine 873 volume depletion 701 renal enzyme processes
quinoneimine 404 Randalls plaques 753 mechanisms of acute kidney injury 7
ranitidine renal excretion
R organic cation transport 62, 63 gadolinium 712
rabeprazole 567 RANTES renal handling of drugs and xenobiot-
radiation nephritis 526–527 immune response 139 ics 43–71
radical formation 237 rapamycin inhibitors 650 ABC transporter family 59–61
radical scavengers rapidly progressive glomerulonephritis endocytosis 48–49
beta-lactams 310 silicon containing compounds 832 glomerular filtration 46
radiocontrast agents 700–708 rash interactions anion-cation transport
adenosine antagonists 706 ACE inhibitors 482 62–63
and aminoglycosides 269 beta-lactams 296 interactions of drugs 61–63
and anesthetic agents 537 D-penicillamine therapy 465, 467 metabolism 63
and cyclosporine 626, 627 gold salt therapy 460 organic anion transport 50–55
animal models 203 proton pump inhibitors 572 organic cation transport 55–59
antioxidant agent 706 rave parties passive reabsorption 46–48
atherosclerosis 701 amphetamines 866 reabsorption by facilitated mecha-
carbon dioxide 704 reactive oxygen species (ROS) nisms 48
clinical findings 700 acute cyclosporine nephrotox. 623 tubular reabsorption 46–49
clinical maneuvers 708 cell culture 231, 232, 234, 238 tubular secretion 49–63
clinical relevance 11 cephaloridine nephrotoxicity 309 renal histology
definition 700 chronic cyclosporine nephrotox. 635 acute cyclosporine nephrotox. 625
diuretics 705 receptor-associated protein renal imaging
endothelin antagonists 707 aminoglycoside transport 271 analgesic nephropathy 407–408
experimental 703 REDOX 229 renal nerve stimulation
fluid administration 704 reduction hydronephrotic kidney 189
heart failure 701 anesthetic agents 538 renal papillary antigen
hemodialysis 707 regeneration urinary biomarkers 110
high osmolar 703 pharmacological aspects 78–79 renal papillary necrosis
histopathology 700 regulatory action 5-aminosalicylic acid 411
hydration 704 pharmacovigilance 88 analgesic nephropathy 400, 404
hypertension 701 regulatory decision-making NSAIDs 424, 433
incidence 700 pharmacovigilance 89 renal parenchyma
iodinated 700 relapsing nephrotic syndrome ACE inhibitors 490
980
INDEX
renal syndromes 423 drug abuse 867 analgesic nephropathy 403

renal transplantation heroin abuse 603–605 beta-lactams 306
Balkan nephropathy 853 in acute kidney injury 10 drug metabolism studies 63
cell culture 230 mushroom nephrotoxicity 764 pH-dependent reabsorption 47
cellular mechanisms 157 paraphenylene diamine 873 poisoning 258
chronic cyclosporine nephrotox. 636 pesticides 836, 837 tubular secretion 62
methanol intoxication 503 phencyclidine abuse 607 violet tree poisoning 868
smoking 898 rheumatoid arthritis Salmonella 296
tacrolimus nephrotox. 646 analgesic nephropathy 403 salt
trimethoprim-sulfamathoxazole 358 chronic cyclosporine nephrotox. 642 loading 430, 740
renal transport systems 310 D-penicillamine therapy 465, 466 sandblasters 832
renin-angiotensin system 483–485 gold salt therapy 460 sangoma 859
acute cyclosporine nephrotox. 619, NSAIDs 437 saquinavir 390
626 silicon containing compounds 836 organic cation transport 57
aristolochic acid nephropathy 761 rheumatologic agents saralasin
chronic cyclosporine nephrotox. 631 dosing in renal failure 937–938 acute cyclosporine nephrotox. 619
lithium treatment 740 rho kinase inhibitor 190 saturnine gout
prostaglandins 421 ribavirin 391 lead nephropathy 777
tacrolimus nephrotox. 647, 649 riboflavin scleroderma
replicative senescence 225, 226, 238 and antiretroviral agents 389 cocaine abuse 606
reserpine rickets seafood
acute cyclosporine nephrotox. 622 ifosfamide therapy 518 mercury exposure 812, 817
resident cells rifampicin 138 seal oil
chronic cyclosporine nephrotox. 633 immune response 138 acute cyclosporine nephrotox. 622
reticulocytosis risedronate 548 secular trend
cadmium-induced renal effects 797 pharmacokinetics 549 Balkan nephropathy 845
retinitis in cytomegalovirus inf. risk management sedatives 609
cidofovir 385 pharmacovigilance 85 dosing in renal failure 939–940
retinol binding protein ritonavir 390 seizures
cadmium-induced renal effects 790 organic cation transport 57 star fruit intoxication 902
mercury exposure 820 rituximab 691 selectins
organic solvents 831 RNA polymerase sP-selectin 630
silicon containing compounds 834 foscarnet 386 urinary biomarkers 112–113
urinary biomarkers 94 rofecoxib 422, 424, 428, 435, 437 selenite 227
retrograde transport Romania selenium
aminoglycosides 272 Balkan nephropathy 844–846 acute cyclosporine nephrotox. 623
retroviruses Round-up 837 aminoglycoside nephrotoxicity 279
antiretroviral agents 387 rubber manufacturing Balkan nephropathy 847
ribavirin 391 and paraphenylene diamine 872 cephalosporins 297
reverse transcriptase in renal failure 888
antiretroviral agents 387 S mercury exposure 814
retroviral 386 S3 segment, proximal tubule semustine 519
rhabdomyolysis mercury exposure 818 senecio 864
acute kidney injury 37 oxygen consumption 44 senescence 226, 231
amphetamine 608 sacroplasmic reticulum sepsis
antiretroviral agents 389 paraphenylene diamine 873 animal models 180
cocaine abuse 605 salicylate Serbia
981
INDEX
Balkan nephropathy 844–846, 847 silicon containing compounds 832 transport 541
serotonin skin-popping sodium bromate
tacrolimus nephrotox. 648 drug injection 599, 600 hair waving 865
serum creatinine skin biopsy sodium thiosulfate
acute cyclosporine nephrotox. 625 gadolinium 711 cisplatin therapy 515
animal model, measurement of injury skin induration solvent exposure
181 gadolinium 709 clinical relevance 15
mercury exposure 821 skin lightning creams sorafenib 525
monitoring of renal function 12 mercury exposure 820 soybean lipid nutrition
proton pump inhibitors 574 mercury poisoning in Kenya 864 acute cyclosporine nephrotox. 624
urinary biomarkers 97–98 SLC34 gene family Spanish fly 862
sevoflurane 539 phosphate cotransporters 580 specific gravity
sexual stimulants slimming urinary biomarkers 100
cantharidin 862 aristolochic acid nephropathy 757, speech disturbance
sheaves of wheat 758, 761 lithium treatment 741
sulfadiazine 354 SMAD 3 231 speed
Shigella 296, 297 SMAD 7 231 amphetamines 866
shock smoking 895 sphingomyelin
NSAIDs 427 and analgesic abuse 406 amphotericin B therapy 329
shrunken kidneys cadmium-induced renal effects 786 spironolactone 498
Balkan nephropathy 852 chronic kidney disease 897 and lithium 740
signal detection diabetes mellitus 897 chronic cyclosporine nephrotox. 632
pharmacovigilance 87 endothelin 896, 897 tubular secretion 62
silicon containing compounds 832–836 glomerulosclerosis 897 spirulina
Balkan nephropathy 847 microalbuminuria 896 acute cyclosporine nephrotox. 623
chemistry 832 proteinuria 896 spontaneous reports
epidemiology 832–835 renal transplantation 898 pharmacovigilance 87
exposure 832 sympathetic overactivity 895 Staphylococci
in renal failure 887–888 smooth muscle actin (alpha-) beta-lactams 295, 314
mechanisms 835–836 chronic cyclosporine nephrotox. 644 vancomycin 281
occupational exposure 832 soda lime star fruit 901–912
pathology 835–836 CO2 absorption 540 intoxication 903–910
silica 832 sodium levels 903
silicates 832 balance juice 909
silicon dioxide 832 renal artery stenosis 485 nephrotoxicity 906–907
silicones 832 depletion neurotoxicity 902–904, 907–910
silicosis 832 acute cyclosporine nephrotox. 619 biochemistry 907–908
Simian virus 40 (SV40) 226 chronic cyclosporine nephrotox. mechanisms 907–910
simvastatin 631, 632 molecular aspects 907–908
animal model of septic injury 182 tacrolimus nephrotox. 649 neurobiological aspects 908–910
chronic cyclosporine nephrotox. 635 dicarboxylate transport system outcome 904–905
sirolimus 650 tubular secretion 49, 52 toxin 910
and cyclosporine 629, 630 excretion 836 treatment 904–905
and tacrolimus 648 restriction STAT3
MDR-glycoprotein transport 61 renin-angiotensin system 483 cellular mechanisms 164
Sjögren’s syndrome retention 428, 435 status epilepticus
chronic cyclosporine nephrotox. 643 angiotensin II 483 star fruit intoxication 903, 908
982
INDEX
staurosporine 190 succinate survival

stavudine 387 organic anion transport 52 aminoglycoside dosing 277
Stephania tetrandra 758 Sudan chronic cyclosporine nephrotox. 637
steroids paraphenylene diamine 871, 873 sympathetic system
allopurinol nephropathy 471 suicide attempt acute cyclosporine nephrotox. 622,
aristolochic acid nephropathy 759 acute kidney injury 609 623
D-penicillamine nephropathy 466 paraphenylene diamine 873 cocaine abuse 605
steroid-resistant nephrotic syndrome sulbactam 295 smoking 895
chronic cyclosporine nephrotox. sulfadiazine 354–356 tacrolimus nephrotox. 648
643 prevention of nephrotoxicity 356 sympathomimetic activity
tubular secretion 49 risk factors of nephrotoxicity 355 cocaine abuse 605
Stevens-Johnson syndrome treatment of nephrotoxicity 356 synapsin
allopurinol therapy 469, 471 urinary solubility 354 acute cyclosporine nephrotox. 622
stoma sulfamathoxazole 356 synaptosomes
5-aminosalicylic acid 411 concentration 356 star fruit intoxication 908
stone formation sulfapyridine 367 syncytial virus bronchiolitis
5-aminosalicylic acid 412 sulfasalazine 400 ribavirin 391
stop-flow sulfhydryl groups syndrome of inappropriate antidiuretic
drug transport studies 45, 49 mercury exposure 818 hormone
strain differences moiety: captopril 482 proton pump inhibitors 569
knockout mouse model 176 sulfobromoftalein synergism
Straws tubular secretion 49 aminoglycosides with other antibiot-
amphetamines 866 sulfonamides 353–356 ics 268
Streptococci immune response 138 syphilis
Streptococcus pneumoniae 295 pH-dependent reabsorption 47 mercury-containing treatment 812
Streptomyces cattleya 295 sulfone 367 systemic inflammation
streptomycin 267 sulindac 424, 428, 430, 431 gadolinium 712
streptozotocin 512, 518, 539 sulphated polysaccharides systemic sclerosis
stress activated protein kinases 163 acute cyclosporine nephrotox. 623 chronic cyclosporine nephrotox. 643
stress proteins sulphisoxazole D-penicillamine therapy 465, 466
cadmium-induced renal effects 789 drug metabolism studies 63
stress response glomerular filtration 46 T
cellular mechanisms 162 sulphoxidation T-cells
striped fibrosis gold salt nephropathy 464 activation by drugs 135
tacrolimus nephrotox. 649 sunitib 525 animal model of septic injury
stroke 439 superoxide dismutase 182 CD28 deficient mice 182
strontium aminoglycoside nephrotoxicity 279 autoreactive 136, 142
in renal failure 884, 887 animal model, measurement of injury drug-specific 138
strychnine 183 immunomodulators
violet tree poisoning 868 beta-lactams 308, 310 CD20+ cells 691
stupor silicon containing compounds 835 CD3+ cells 691
drugs overdose 609 superoxide radicals CD52+ cells 692
heroin abuse 604 radiocontrast agents 701 knockout mouse model
sublethal injury suppurative skin infections CD4+ cells 177
chronic cyclosporine nephrotox. 634 heroin abuse 599, 600 CD8+ cells 177
succimer supra-bulbar symptoms NSAIDs 431, 432
lead nephropathy 774 lithium treatment 741 proton pump inhibitors 572
983
INDEX
regulatory 133, 134, 138 and lithium 733, 737, 739 chronic cyclosporine nephrotox. 633
subsets 132–133 thick ascending limb TNF-alpha: See tumor necrosis factor-
Th1 and Th2 cells 132–134 amphotericin B therapy 327 alpha
T-reg cells 133, 134, 138 lithium transport 727 tobramycin 267
tachycardia thienamycin 295 and beta-lactams 314
phencyclidine abuse 607 thienyl 314 toluene 828
tacrolimus 646–650 thimerosal 812 torsemide
acute kidney injury 31 thiourea 310 and lithium 739
acute nephrotoxicity 646–649 thrombocytopenia toxic metabolites
cell culture 230 cocaine abuse 606 ethylene glycol 503
chronic nephrotoxicity 649–650 D-penicillamine therapy 465 toxoplasmosis
experimental model 649 gold salt therapy 460 pyrimethamine 367
microcirculation model 185 valacyclovir 385 toxoplasmic encephalitis
proton pump inhibitors 570 thrombomodulin sulfadiazine 354, 355
Takaout beldia 871 acute cyclosporine nephrotox. 621 trace metal disturbances in renal fail-
Tamaris Orientalis 871 thrombopenia ure 883–894
Tamm-Horsfall glycoprotein 107 immune response 138 accumulation 886–889
taurine thromboplastin 606 hemodialysis 885–886
acute cyclosporine nephrotox. 623 thrombotic microangiopathy mechanisms 883–886
tazobactam 295 acute cyclosporine nephrotox. 626 metal-metal interactions 889
tea acute kidney injury 32 peritoneal dialysis 886
Balkan nephropathy 847 immunomodulators 685 sources 883–886
teicoplanin 284 valacyclovir 385 toxicity 886–889
telomerase 226, 239 thrombotic thrombocytopenic purpura tracheostomy
temafloxacin 371 cocaine abuse 606 paraphenylene diamine 877
tenofovir 387 valacyclovir 385 transcription factors
tenoposide 59 thromboxane 435 cellular mechanisms 157
test strip screening acute cyclosporine nephrotox. 621 transcriptomics 229
urinary biomarkers 96 animal model of septic injury 182 transepithelial electrical resistance
tetracycline receptor antagonists (TEER) 238
pharmacokinetics in uremia 915 acute cyclosporine nephrotox. 622 transferrin
tetraethylammonium thymic factor FTS 309 cadmium-induced renal effects 797
beta-lactams 296 thymidine kinase cell culture 227
cephalosporins 297 acyclovir 384 mercury exposure 820
organic cation transport 55–59 thymoglobulin 693 silicon containing compounds 835
tetrandrine 760 thyroxine urinary biomarkers 104
theophylline 204 lithium treatment 741 transforming growth factor beta
and amphotericin B 331, 332 ticarcillin anti-TGF-beta-antibodies
hemoperfusion 256 and amphotericin B 333, 342 chronic cyclosporine nephrotox.
radiocontrast agents 703, 706 tienilic acid 498 632
Therapeutic Goods Administration tigecycline 285 aristolochic acid nephropathy 762
proton pump inhibitors 571 Tik cell culture 230, 231
thermometer factories 813 amphetamines 866 chronic cyclosporine nephrotox. 632,
thiamine tiludronate 634
and antiretroviral agents 389 clinical toxicity 554 gene h3
thiazides 496, 498, 499, 500 tircarcillin 296 chronic cyclosporine nephrotox.
allopurinol therapy 470 tissue inhibitor of metalloproteinase 645
984
INDEX
models of ischemia 200 rapamycin inhibitors 650 ulcers

tacrolimus nephrotox. 649 toxicity in acute kidney injury 8 analgesic nephropathy 406
transfusion tubulitis heroin abuse 599, 600
poisoning 256 proton pump inhibitors 574 ultrasonography
transmetallation urinary biomarkers 100–101 bone density measurement 793
gadolinium 714 tubular dilatation indinavir 390
trehalase HIV nephropathy 602 uninephrectomy
cadmium-induced renal effects 791 lithium treatment 731 animal model of ischemic injury 178
tremor tubular dysgenesis, fetal United States Renal Data System
lithium treatment 741 ACE inhibitors 488 (USRDS)
mercury exposure 812, 815, 816 tubular necrosis risk factors for progressive renal
Treponema 296 aristolochic acid nephropathy 758 failure 13
triamterene 427, 498 immunomodulators 685 uranium
and lithium 740 tubular reabsorption Balkan nephropathy 847
triazolam 139 renal handling 46 urea clearance
trichlorophenoxyacetic acid 837 tubular secretion urinary biomarkers 97
Tricholoma equestre 763 drug transport 49 ureidopenicillins 313
trifluoroacetic acid 539 tubulo-glomerular feedback uric acid
trimethoprim-sulfamathoxazole 354, amphotericin B therapy 330 organic anion transport 52
356–362 diuretics 496 uricosuria
and aminoglycosides 358, 360 models of ischemia 201 probenecid 61
and amphotericin B 360 tubulo-interstitial nephritis urinary biomarkers 91–130
and cyclosporine 358 aristolochic acid nephropathy 868 amount of drug 93
and penicillin 358 tubulointerstitium biologically effective dose 93
multisystemic reactions 358 proton pump inhibitors 573 biomarkers of effect 93–95
tripelennamine 597, 600 tumor necrosis factor-alpha biomarkers of exposure 93
trypanosomiasis animal model of septic injury 182 biomarkers of susceptibility 95–96
pentamidine 362 cell culture 232 blood levels 93
tryptophan 310 experimental morphine injections 597 blood urea nitrogen 97
tuberculosis immunomodulators 685, 688, 692 categories 92–96
Balkan nephropathy 845 TUNEL staining cell adhesion molecules 112–114
tubocurarine animal models 175 creatinine clearance 98
organic cation transport 57 models of ischemia 200 cytokines 110–112
tubular acidosis Tunisia definitions 92
cisplatin therapy 514 paraphenylene diamine 871 enzymuria 107–109
heroin abuse 600 two-photon microscopy glomerular filtration rate 98–100
tacrolimus nephrotox. 648 microcirculation model 193 individual health assessment 92
tubular atrophy tyrosinase prediction 94
Balkan nephropathy 848, 849, 851, 852 paraphenylene diamine 873 presence of clinical disease 94
lithium treatment 731 tyrosine kinase proteinuria 101–107
zidovudine 388 anti-VEGF therapy 524 renal blood flow 100
tubular basement membrane safety of drugs 92
proton pump inhibitors 572 U serum creatinine 97–98
tubular cells Ukrainians test strip screening 96
acute cyclosporine nephrotox. 620, Balkan nephropathy 845 tissue levels 93
621, 624 ulcerative colitis tubular function 100–101
mercury exposure 819 organic solvents 830 types 92–96
985
INDEX
underlying disease 95 prevention of nephrotoxicity 284 endothelin 115

urea clearance 97 renal transport 282 in acute kidney injury 8
urinalysis 96–97 resistant Enterococci 281 mercury 204
urine microscopy 96–97 therapeutic drug monitoring 283–284 prostaglandin synthesis inhibition
urinary tract cancer varicella-zoster virus 488
analgesic nephropathy 406 acyclovir 384 radiocontrast agents 701, 704, 705
urinary tract infections cidofovir 385 vasodilation
quinolones 368 varnishes ACE inhibitors 483, 485, 487, 488
trimethoprim-sulfamathoxazole 356, organic solvents 828 radiocontrast agents 703, 705
357 vascular cell adhesion molecule-1 vasodilators
urinary tract obstruction urinary biomarkers 114 drug dosing in renal failure 931
sulfadiazine 355 vascular endothelial growth factor vasopressin
urine microscopy anti-VEGF agents 524 acute cyclosporine nephrotox. 623
urinary biomarkers 96 chronic cyclosporine nephrotox. 634 cell culture 226, 227
urothelium vascular leak diuretics 501
aristolochic acid nephropathy 759 interleukin-2 therapy 523 vecuronium
Balkan nephropathy 846 vascular nephrosclerosis organic cation transport 57
urticaria Balkan nephropathy 848 verapamil
proton pump inhibitors 572 vascular resistance cell culture 230
uveitis prostaglandins 421 organic cation transport 57, 58, 61, 62
acute cyclosporine nephrotox. 628 vascular smooth muscle cells pentamidine 364
chronic cyclosporine nephrotox. 641 amphotericin B therapy 330 very late activation antigen-4
vascular surgery urinary biomarkers 114
V gadolinium 712 vesicles
vacuolization vascular tone drug transport studies 45
aminoglycoside nephrotoxicity 273 microcirculation model 185 video-EEG
amphotericin B therapy 327 vasculitis star fruit intoxication 908
valacyclovir 384 allopurinol therapy 470 vimentin
tubular reabsorption 48 amphetamines 867 cell culture 225
valproate analgesic nephropathy 406 vinblastine
and beta-lactams 306 D-penicillamine therapy 465, 467, 468 MDR-glycoprotein transport 60
valsartan diuretics 499 vincristine 59
acute cyclosporine nephrotox. 621 paraphenylene diamine 875 MDR-glycoprotein transport 60
chronic cyclosporine nephrotox. 631 small vessel 835 violet tree 868
valvular heart diseases vasoactive hormones viruses
aristolochic acid nephropathy 759 prostaglandins 420 Balkan nephropathy 846
vancomycin 281–285 vasoconstriction Visicol 581
absorption 281 acute cyclosporine nephrotox. 619 vitamin C
alternative antibiotics 284–285 acyclovir 384 aminoglycoside nephrotoxicity 279
and aminoglycosides 269 amphotericin B therapy 328, 330 oxalate 750
and beta-lactams 313 angiotensin II 483 vancomycin nephrotoxicity 284
and cyclosporine 627 animal model of nephrotoxic injury vitamin D
distribution 281 180 cadmium-induced renal effects 794
elimination 282 animal model of septic injury 181 heroin abuse 604
epidemiology 282–283 animal models 176 trace metal disturbances in renal
nephrotoxicity 283 cell culture 225, 237 failure 884
pharmacokinetics 281–282 cocaine abuse 606 vitamin E
986
INDEX
acute cyclosporine nephrotox. 623 X

aminoglycoside nephrotoxicity 279 x-ray fluorescence
beta-lactams 310 lead nephropathy 774
cephalosporin nephrotoxicity 310 mercury determination 816
vancomycin nephrotoxicity 284 xanthine oxidase 469
vitamin K deficiency xanthine stone formation
beta-lactams 300 allopurinol therapy 469
volatile anesthetics 539 xantochromia
volume contraction Balkan nephropathy 850
acyclovir 384 xenobiotics
NSAIDs 427 urinary biomarkers 93
pesticides 836 xylene 828
volume depletion
beta-lactams 313 Y
cocaine abuse 606 yams 868
diuretics 497
phencyclidine abuse 607 Z
vomiting zerealenone
star fruit intoxication 903 Balkan nephropathy 847
von Kossa stain zidovudine 387
calcium phosphate deposition 581 MRP transporters 59
von Willebrand factor tubular secretion 63
acute cyclosporine nephrotox. 620, zinc
630 gadolinium 715
cell culture 225 in renal failure 888
voriconazole 339 refinery 796
vulnerability of the kidney 44 smelters
cadmium-induced renal effects 786
W zoledronic acid 548
warfarin clinical toxicity 555
glomerular filtration 46 pharmacokinetics 549
pH-dependent reabsorption 48 zwitterions
water retention 428 beta-lactams 312
Wegener’s granulomatosis cephalosporins 298
silicon containing compounds 835 organic cation transport 58, 62
whiskey
lead nephropathy 775
WHO
Drug Monitoring Centre
proton pump inhibitors 571
Wild Wisteria 868
Wilson’s disease
copper sulphate 866
D-penicillamine therapy 466
World Health Organization
mercury-containing products 813
987

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44.

Drug dosage in renal failure

Appendix: Drug dosing in renal failure

ACE: angiotensin-converting enzyme

ment required alysis GFR 10−50

FK level GFR<10 ml/min <10 ml/min

75% GFR 10−50

Nicotinic acid 1 g t.i.d. 2 g t.i.d. None 100% 50% 25% No data NC NC NC

Table 6. Gastrointestinal agents

disease (CCr less than 30 ml/min); no formal studies

Au: define qhs

Table 10. Anti-Parkinson agents

Methylprednisolone 4−48 mg q. 24 hr < 10 100% 100% 100% Group toxicity NC NC NC

Prednisolone 5−60 mg q. 24 hr 34 100% 100% 100% Group toxicity NC NC NC

AA aristolochic acid AmB amphotericin B

BBM brush border membrane CPK creatinine phosphokinase

EDD extended daily dialysis HA hyaluronic acid

ITAM immunoreceptor tyrosine activated motive mPDS methylprednisolone

OA osteoarthritis PPI proton pump inhibitor

SNS sympathetic nervous system VSMC vascular smooth muscle cells

Symbols acetylcholine 202, 205 cyclosporine nephrotox. 625

foscarnet 386 agricultural activity urinary biomarkers 109

urinary biomarkers 94 cephalosporins 303 vasoconstriction 328

anemia juxtaglomerular apparatus 188 antibacterial agents

cell culture 229, 231, 233, 237 B soil 848

cell culture 233 renal transport 549–552 hair waving 865

urinary biomarkers 104 candoxatrilat cathinonine

myoglobin 237 cephamycin 298 tacrolimus nephrotox. 649

age 17 MDR-glycoprotein transport 60 star fruit intoxication 902

silicon containing compounds 832, namic injury 619–624 cyst formation

pathogenesis of nephropathy 467–468 heroin abuse 600 diltiazem

cell culture 238 neonatal aminoglycoside transport 272

NSAIDs 431 erythropoietin cidofovir 386

ACE inhibitors 490 ethylene glycol 867 gout

chronic cyclosporine nephrotox. 637 mitomycin therapy 522 herpes viruses

injury 183 allopurinol therapy 470 ACE inhibitors 485

low molecular weight proteins depletion vancomycin 284

MTT assay 229, 230, 235 myosin necrotizing arteritis

enzymuria nitrosoureas 518–520 clinical relevance 17

orellanine 764 cadmium-induced renal effects 790, models of ischemia 198

ophthalmic effects 876 Peptococcus 296 phenmetrazine 608

cadmium uptake 787 252 allopurinol nephropathy 470, 471

renal syndromes 423 drug abuse 867 analgesic nephropathy 403

staurosporine 190 succinate survival

models of ischemia 200 rapamycin inhibitors 650 ulcers

underlying disease 95 prevention of nephrotoxicity 284 endothelin 115

acute cyclosporine nephrotox. 623 X

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