药物性肾损伤发病机制及防治进展

摘要

目前因药物种类繁多及药物滥用问题严重,药物性肾损伤日益增多.其发病机制多种多样,如血流动力学改变、药物对肾组织的直接损害、炎症损伤、肾内梗阻、横纹肌溶解及代谢紊乱等.药物常通过多种途径引起肾脏损伤,每种途径又可相互影响,加重肾脏损伤.由于其早期临床症状无特异性,易被忽视.积极预防、用药后密切监测、及时干预对该病的发生发展非常重要,临床上主要以对症支持治疗为主,一旦发生肾损伤,预后欠佳.%At present drug-induced renal injury is increasing due to a wide variety of drugs and drug abuse problem.Many pathogenesis includes hemodynamic changes,drug damage,inflammation,immunolesion,renal obstruction,rhabdomyolysis,metabolic disorders and so on.Each pathogenesis can influence each other.The complex pathogenesis and non-specific clinical symptoms in early stage lead to missed diagnosis.Early prevention,monitoring and intervention are important in the development of the disease.Supportive therapy is a critical part of the treatment.Some patients with renal impairment have poor prognosis.