肾脏担负着大部分药物及其代谢产物在肾小球过滤、肾小管主动回吸收、排泄以及被动扩散等作用。由药物所引起的肾脏损害,通称药物性肾病(Drug induced renal disease),其发生率未定,有人认为急性肾功能衰竭中约5～20％系药物或化学物品引起。有文献报道医源性的急性肾功能衰竭,死亡率可高达40～70％。药物产生肾脏损害的机制较为复杂,如对肾脏的直接损害;减少肾血流量而损伤肾脏;机体对药物的超敏反应(Hypersensitivity reaction);使机体失水或输尿管阻塞等。兹分述如下。 1.药物导致机体内水及盐类丢失——肾前性作用肾前性作用包括药物作用导致机体内水和盐类丢失增加、分解代谢增强以及产生血管闭塞等。 (1) 机体内水和盐类丢失增加:常见于应用过 Most of the kidneys responsible for the drug and its metabolites in the glomerular filtration, tubular active absorption, excretion and passive diffusion and so on. Kidney damage caused by drugs, commonly known as drug induced renal disease, is undetermined, and it is thought that about 5 to 20% of acute renal failure is caused by drugs or chemicals. There are reports of iatrogenic acute renal failure, the mortality rate can be as high as 40 to 70%. The mechanisms by which drugs cause kidney damage are more complex, such as direct damage to the kidneys, renal blood flow reduction and kidney damage, the body’s hypersensitivity reaction to drugs, and water or ureteral obstruction. It is divided as follows. 1. Drugs lead to the loss of water and salts in the body - prerenal effects Prerenal effects include drug effects that lead to increased loss of water and salts, catabolism and vasoocclusion in the body. (1) the body of water and salt loss increase: common in the application