Until recently the acute kidney injury is define as acute onset low in glomerular function, 1 . Nephrotoxic agents are one of the major causes of acute kidney injury, it’s found in some drugs and substance, drugs that mainly has significant impact on declining the performance and function of the nephrons. These nephrotoxic drugs include analgesics, chemotherapeutics, antimicrobial, immunosuppressants, and Orlistat.
While using these drugs the dose should be determined carefully to avoid harmful side effects of these drugs, 2,3 In this study we’re focusing on some Anti-biotics toxicity to the kidney and lead to Acute Kidney injury , our field of research include vancomycin , Aminoglycoside , Amphotericin B and cisplatin .
Cisplatin also is one of the potent chemotherapy drugs that most widely used, how ever the limitation of cisplatin use is the side effects in normal organs and tissues mainly the kidney it cause nephrotoxicity. 4 cisplatin chemotherapy nephrotoxicity was reported in the early clinical trials during testing the drug, The study shows about one-third of patients treated with cisplatin, will developed nephrotoxicity that appear within 10 days of administration of the drug which is a high percent , its manifested as increase serum creatinine and decrease serum potassium and magnesium and decrease the GFR .4
Amphotericin B is an anti-fungal medication that is fundamental due to its higher coverage to fungal spices however there is downside to its use, which is the nephrotoxicity effect. 5
Aminoglycoside are efficient bactericidal antibiotics that its major effect is against infections of gram-negative bacteria. About (58%) of intensive care units (ICUs) patients treated aminoglycoside expose to nephrotoxicity, which may decrease about more than 20% of the glomerular filtration rate (GFR) , and also developed with low the calcium, potassium, and magnesium serum levels and, enzymuria, and glycosuria and aminoaciduria . 5
One of the studies shows the result of nephrotoxicity in 980 patients using aminoglycoside during period of time analyze, 360 of them achieve the inclusion criteria. Half of these 360 patients undergo nephrotoxicity and kidney dysfunction, nephrotoxicity of gentamicin considers to be 60% and amikacin 56.7% , oliguria developed with only 3 subjects (1.41%) from the 209 . 6
ICU patients are predispose to acute kidney injury and kidney failure because they are critically ill and under pathological stresses e.g. dehydration, septic shocks and low immunity status. So, its crucial to study the drugs that has effect on their vital organs to protect it from varies injuries, until now there’s no evidence available on the degree of toxicity on the nephrons after 24 hour of administration of these drugs on ICU patients. Our aim is the patient who exposure to nehrotoxic agents to evaluate the degree of toxicity in the nephrons after 24 hour of administration and identified the need of hemodialysis or not, and the duration of hemodialysis they require.