Kidney is either of the two bean-shaped excretory organs that filter wastes (especially urea) from the blood and excrete them in urine which passes out of the kidney through ureters to the bladder. It also plays an important role in homeostasis i.e. physiological equilibrium that is actively maintained by several complex biological mechanisms that operate via the autonomic nervous system to offset disrupting changes.

Drug induced kidney disorders:

A large number of drugs are known to induce renal lesions. Drug-induced kidney diseases constitute a significant chunk of both acute & chronic renal disorder cases in present day clinical practice. These disorders are quite common, numerous and often under-diagnosed. Some of these have been mentioned below:

Functional renal failure: It usually occurs upon treatment with Angiotensin Converting-Enzyme Inhibitors & Nonsteroidal anti inflammatory drugs:

Angiotensin-converting-enzyme Inhibitors: These are the inhibitors of Angiotensin-converting-enzyme & are highly effective drugs given in ventricular dysfunction. It induces the efferent arteriole of glomerulus to constrict and prevent a drop in glomerular filtration rate.

Nonsteroidal anti inflammatory drugs (NSAIDs): These drugs inhibit the formation of prostaglandins by cyclooxygenase inhibition. Prostaglandins have a net vasodilatory effect on the kidneys. Drug induced irregularities include urine concentration disorders & Fanconi's syndrome which is associated with proximal portion of nephrons.

Interleukin-2: Clinical trials using recombinant interleukin-2 immunotherapy for the treatment of metastatic cancers reported many side effects on renal function and were collectively called as "pre-renal azotemia" i.e. accumulation in the blood of nitrogen-bearing waste products like urea that are usually excreted in the urine.

Organic renal failure: Many drugs can induce various renal lesions damaging the nephrons. Some of these drugs have been listed below:

Mercury compounds: Various antiseptics, laxatives, skin lightening creams and vaginal contraceptives containing mercury have been reported to cause a significant number of cases of Nephrotic syndrome which is characterized by edema and large amounts of protein in the urine and usually increased blood cholesterol. It usually associated with glomerulonephritis.

Sulfhydryl drugs: Various sulfhydryl containing drugs like Thiopronine, Pyrithioxine, 5-thiopyridoxine etc. are used mostly in the treatment of rheumatoid arthritis. Various cases of Nephrotic syndrome have been reported in people who were prescribed these drugs for the treatment for rheumatoid arthritis.

Cephalosporins: These are several broad spectrum antibiotic substances obtained from fungi and are related to penicillin. Many antibiotics belong to this class of compounds. Renal damage due to cephalosporins is uncommon, but well documented.

Polymyxines: These are the toxic antibiotics obtained from a particular soil bacterium. These can be nephrotoxic, but they are now rarely used. Some cases of ciprofloxacin induced acute renal failure have also been reported.

Radio contrast materials: These may be one of the culprits for causing acute renal failure. Radio contrast induced acute renal failure has been reported following many radiographic procedures, like excretory urography, coronary angiography etc., in many cases.

Streptozotocin: It is one of the most nephrotoxic drugs in the group of nitrosoureas. The drug induced interstitial nephritis is generally due to a hypersensitivity reaction rather than a toxic effect. Various anticancer drugs like cisplatin often lead to nephrotoxicity.