摘要
目的为了提高对药源性肾损伤的认识,对药源性肾损伤的发展机制研究进展进行分析综合,为预防药源性肾损伤提供参考。方法通过检索Pubmed、ScienceDirect等权威数据库,总结国内外最新文献对发病原因、药源性肾损伤的机制、典型疾病及药物安全性评价方法等进行综述。结果药源性肾损伤临床表型分为急性肾损伤、肾小球损伤、肾小管损伤及肾结石四类;药源性肾损伤发生机制主要涉及直接作用、氧化应激作用、免疫炎症作用、酸碱平衡紊乱、药物影响转运蛋白五类;临床上典型的药源性肾损伤主要有血栓性微血管病、马兜铃酸肾病和范可尼综合征;还需要更加敏感的药源性肾损伤的安全性评价方法。结论应该加深对药源性肾损伤的临床表型、发生机制和典型疾病的认识,研究和发展全面可靠的药物安全性评价方法,从而促进提高对药源性肾损伤的防控水平。
Objective To help gain keen insights into drug-induced kidney injury and prevent such injury by analyzing the mechanism of this disease Methods By searching PubMed,ScienceDirect and other authoritative databases,the latest literature was summarized on the pathogenesis,mechanism,typical diseases and drug safety evaluation methods of drug-induced kidney injury.Results The clinical phenotypes of drug-induced kidney injury could be divided into four categories:acute renal injury,glomerular injury,renal tubule injury and renal calculus.The mechanisms of drug-induced kidney injury could be divided into six categories:direct action,oxidative stress,immune inflammation,acid-base balance disorder,drug effect on transporters.Typical drug-induced kidney injury included thrombotic microangiopathy,aristolochic acid nephropathy and Fanconi syndrome.More sensitive methods for safety evaluation of drug-induced kidney injury were needed.Conclusion We should improve our understanding of the clinical phenotypes,pathogenesis and typical diseases of drug-induced kidney injury and try to establish comprehensive and reliable drug safety evaluation methods so as to update our knowledge of drug-induced kidney injury while enhancing prevention and control of this disease.
作者
邱彩霞
杨翠平
靳洪涛
QIU Caixia;YANG Cuiping;JIN Hongtao(New Drug Safety Evaluation Center,Institute of Materia Medica,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100050,China;Beijing Union-Genius Pharmaceutical Technology Co.,Ltd,Beijing 100176,China)
出处
《中国药物警戒》
2019年第11期688-694,702,共8页
Chinese Journal of Pharmacovigilance
基金
十三五重大新药创制专项(2018ZX09201017-005
2018ZX09711001-002-001):吸入毒性和儿童用药等特色创新药物安全性评价关键技术研究
新技术新方法在药物毒性中的应用
关键词
药源性肾损伤
机制
临床表型
典型疾病
研究进展
drug-induced kidney injury
mechanism
clinical phenotype
typical disease
research progress
作者简介
邱彩霞,女,在读硕士,药物毒性作用机制;通信作者:杨翠平,女,博士,副研究员·硕导,药代动力学与毒代动力学研究。E-mail:yangcuiping@imm.ac.cn;通信作者:靳洪涛,男,博士,研究员·硕导,药物毒性机制与干预研究。E-mail:jinhongtao@imm.ac.cn。
