Nephrotoxicity
Drug or toxin-induced kidney damage
Definition
Nephrotoxicity is kidney injury caused by exposure to medications, contrast agents, or other toxins. It may be reversible if identified early.
Common Nephrotoxic Agents
- Aminoglycosides (gentamicin, tobramycin)
- Vancomycin
- NSAIDs
- ACE inhibitors/ARBs (in renal artery stenosis or volume depletion)
- Iodinated contrast
- Chemotherapy (cisplatin, methotrexate)
- Lithium
- Amphotericin B
Nursing Interventions
- Monitor renal function: BUN, creatinine, GFR, urine output
- Hold nephrotoxic drugs if creatinine rising
- Ensure hydration pre- and post-contrast
- Trough monitoring for vancomycin and aminoglycosides
- Avoid combining multiple nephrotoxins
- Dose adjust per renal function
NCLEX Relevance
Hydration before IV contrast (monitor creatinine).