Renal metabolism and nephron structures are extremely complex and, therefore, vulnerable in a variety of ways. Since many drugs and other substances are capable of causing serious kidney damage, and the list of potentially hazardous compounds grows yearly, it is important that the physician have a good working knowledge of the subject of toxic nephropathy.
Toxic nephropathy is a general term used to categorize any adverse functional or structural changes in the kidney due to the effect of a chemical or biological product that is inhaled, ingested, injected, or otherwise absorbed, or that yields toxic metabolites with an identifiable adverse effect on the kidneys. By extension, the concept of toxic nephropathy is occasionally applied to the adverse renal effects that occur when physiological substances circulate in concentrations greater or less than normal (eg, hypercalcemic, hyperuricemic, or hypokalemic nephropathy).
Types of Reactions
A number of different mechanisms may be involved
Schreiner GE. Toxic NephropathyAdverse Renal Effects Caused by Drugs and Chemicals. JAMA. 1965;191(10):849–850. doi:10.1001/jama.1965.03080100067015