Nephrotoxin

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definition

Under nephrotoxins (or body's kidney poisons ) is defined as body's toxic substances ( toxins ), specifically the cells of the kidney ( Greek nephros ) damage. One speaks of the nephrotoxicity of such agents . Many of the nephrotoxic or toxirenal substances, however, do not count among the nephrotoxins. In this respect, confusion with the English nephrotoxicity should be avoided; English does not differentiate between nephrotoxins and other kidney toxins.

Even Hans Joachim Sarre counts the exogenous kidney toxins (mistakenly?) To the nephrotoxins. He mentions organic solvents , mercury salts , glycols , sulfonamides and animal and vegetable poisons.

Explanation

A toxin (from ancient Greek τοξικόν toxikón, German 'poison') is a poison that is (naturally) synthesized by a living being. So all unnatural poisons do not count as toxins. The poisons effective in humans are divided into toxins and other poisons. The generic term for medically effective toxins is toxic . The adjective toxirenal means arising from kidney toxins . Under a toxicosis is meant the poisoning only by metabolic products (or metabolic intermediates) of the body. A Toxon is part of the diphtheria toxin , the paralysis caused and kidney damage. The nephrotoxicity or kidney toxicity of the individual toxins depends on their concentration in the tissue. With regard to the dosage of possibly nephrotoxic drugs, see on the Internet for example at www.dosing.de.

Classification of kidney toxins

Kidney toxins include mycotoxins , heavy metals , chromates , arsenic , antimony , organic solvents , some antibiotics , steroids , phenylbutazone, and some contrast agents . Especially phenacetin and paracetamol can (especially in combined long-term ingestion) a so-called Analgesic cause. Overall, the non-steroidal anti-inflammatory drugs (today mainly diclofenac ) are toxic to the kidneys.

Bacterial or non-bacterial antigens are also referred to as nephrotoxins , which lead to the formation of antibodies or immune complexes , which in turn trigger glomerulonephritis and thus damage the kidneys.

The endogenous and exogenous kidney toxins can be classified as follows:

Pathogenesis

By definition, nephrotoxins cause kidney disease ( kidney damage , nephropathy ). Not all kidney failure is due to kidney disease . The uremia toxins , on the other hand, cause renal insufficiency, but not necessarily also kidney disease. The extrarenal kidney syndromes according to Wilhelm Nonnenbruch describe renal insufficiency without kidney disease. These are, for example, cardiorenal syndrome or hepatorenal syndrome .

Web links

Individual evidence

  1. ↑ Maxim Zetkin , Herbert Schaldach (Ed.): Lexikon der Medizin , 16th edition, Ullstein Medical, Wiesbaden 1999, ISBN 978-3-86126-126-1 , p. 1379.
  2. ↑ Willibald Pschyrembel: Clinical Dictionary , 267th edition, de Gruyter , Berlin, Boston 2017, ISBN 978-3-11-049497-6 , p. 1242.
  3. ↑ Hans Joachim Sarre : Kidney diseases , 4th edition, Georg Thieme Verlag, Stuttgart 1976, ISBN 3-13-392804-X , p. 379.
  4. ^ Wilhelm Dultz: DGB Foreign Words Lexicon , German Book Association , Berlin, Darmstadt, Vienna 1965, 491.
  5. ↑ Günter Thiele (ed.): Handlexikon der Medizin, Urban & Schwarzenberg, Munich, Vienna, Baltimore no year, Volume 3 (L − R), p. 1733.