What Is Nephrotoxicity?

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  • Written By: Mary McMahon
  • Edited By: Shereen Skola
  • Last Modified Date: 30 March 2020
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Nephrotoxicity refers to damage to the kidneys that is caused by chemical exposure. Some medications can damage the kidneys when administered at high concentrations or over an extended period of time, and nephrotoxic compounds are also present in nature as well as manufacturing settings. If patients do not receive treatment, they can develop kidney failure, losing the ability to filter the blood and produce urine. This can become rapidly fatal.

The definitive way to diagnose nephrotoxicity is with a blood test to check on the levels of certain compounds, like creatinine and Blood Urea Nitrogen (BUN). If these are elevated, it suggests kidney function may be impaired. Imaging of the kidneys may reveal a change in size, such as significant swelling or shrinkage, which indicates the kidneys are damaged. Once nephrotoxicity is identified, the next step is to determine the cause so it can be treated.

Many medications can cause nephrotoxicity by disturbing the cardiovascular system or the kidneys themselves. This is a known side effect that may be considered when balancing the risks of various treatment options. Patients on these medications may need to be monitored to assess kidney function so the treatment plan can be adjusted if the patient’s kidneys start to become strained. For people who already have reduced kidney function, a medical practitioner may recommend a renal dose adjustment, lowering the amount of medication used to limit strain on the kidneys.


Some poisons and toxic chemicals can also cause nephrotoxicity. These are not designed to be ingested but patients can be exposed to them as a result of poor safety controls, deliberate introduction to the environment, or lack of experience. In these cases, patients may develop symptoms of kidney damage like increased or decreased urination, changes in urine color, and abdominal pain. A blood test can show that nephrotoxicity has occurred, and the patient can receive treatment. This may include dialysis to clear the toxins safely from the body.

Certain compounds found in nature, like plants and mushrooms, have a potential to be nephrotoxic. This may be designed as a defense or could be a byproduct of another biological process. Consuming them can make organisms very ill, especially if they eat a large amount. This can be a problem with animals like cattle, which may freely graze on all the plants they see even if some are toxic. If a herd is not closely watched, multiple cows could become sick or die before the problem is identified.


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