Clinical Nephrotoxins: Renal Injury from Drugs and Chemicals [Hardcover]

M.E. de Broe (Editor), G.A. Porter (Editor), W.M. Bennett (Editor), G.A. Verpooten (Editor)

Book Description

ISBN-10: 0792336119 | ISBN-13: 978-0792336112 | Publication Date: February 28, 1998 | Edition: 1

A comprehensive handbook on all aspects of adverse effects by drugs, chemical substances and radiation on the kidneys. The importance of the toxicity of drugs and other substances on the kidneys is increasingly recognized. The book consists of a general part which deals with such themes as clinical relevance and clinical syndromes of nephrotoxicity, renal handling of drugs and pathological expression of nephrotoxicity. The second part includes the specific drugs, for instance the anti-infectious agents, anti-inflammatory drugs, cardiovascular drugs, anti-cancer drugs, etc. The last part deals with prevention consisting of early markers, principles of drug dosage in renal failure and practical dosage.

Editorial Reviews

From The New England Journal of Medicine

Toxic-waste dumps, ancient Chinese herbal remedies, and over-the-counter medications -- each has nephrotoxic potential. As many as 30 percent of cases of end-stage renal disease may have been caused or exacerbated by nephrotoxins, and 20 percent of cases of acute renal failure are attributable to drugs. In the United States, end-stage renal disease develops in no fewer than 2000 to 5000 people each year because of known or probable nephrotoxicity. With so many nephrotoxins, an easy-to-use guidebook would be welcome. In Clinical Nephrotoxins, a group of internationally recognized authorities has sought to assemble a "comprehensive handbook on all aspects of adverse effects by drugs, chemical substances and radiation on the kidneys." However, radiation-related nephrology, which is important in the context of bone marrow transplantation, is not discussed in the book.

Is this a book that belongs on the shelf of every nephrologist and every specialist in occupational medicine? It may be, but for varied reasons. The first 100 pages discuss general mechanisms of renal injury, beginning with a commendable review of the renal handling of drugs and xenobiotics and ending with a unique chapter on experimental models of nephrotoxic injury, in which five authors or groups of authors write about the experimental models they favor. This chapter will serve as a useful review for readers who are studying renal pathophysiology for the first time or for those wishing to revisit the subject after a long absence, but it will be of limited direct interest to those focusing on patient care. The chapter on urinary biomarkers of nephrotoxicity, in the final section of the book, is a thorough review of clinical pathology, but it fails the clinician by not specifying which of the many tests surveyed should be used routinely and under what circumstances.

Several chapters will be especially useful to clinicians. The one on cisplatin and carboplatin has an algorithm for preventing cisplatin-induced renal injury that will be useful to nurses and physicians who administer cisplatin. The chapter on cyclosporine and tacrolimus is a succinct compilation of a voluminous literature. Unfortunately, the discussion of treatment for cyclosporine-induced thrombotic thrombocytopenic purpura is only two sentences long. Some chapters contain information not easily found elsewhere. For example, there is a chapter on the nephrotoxic effects of OKT3 monoclonal antibody (muromonab-CD3), a syndrome that is not well recognized. There is an excellent chapter on renal disease associated with drug abuse. Another chapter is devoted to renal injury caused by pesticides and herbicides. Even more information on these subjects would have been desirable. A chapter on the nephrotoxicity of herbal remedies and food additives is welcome in view of the strong demand for alternative therapies. However, five pages hardly do justice to this subject.

The main imperfection of this work is its lack of timeliness. Many books suffer from a long interval between the initial submission of the contributions and publication. This book has a publication date of 1998, yet only one chapter cites even a single reference from 1997, and only five chapters cite 1996 references (some added in proof), whereas six chapters cite works published only in 1993 or earlier, and in five chapters, the references are no more recent than 1992. With the rapid pace of clinical medicine, lack of up-to-date information can make a reference work ineffectual. This book, for example, has an entire chapter on the nephrotoxic effects of angiotensin I-converting enzyme inhibitors, but the category of angiotensin II-receptor antagonists is not even mentioned, even though four of these drugs are now available in the United States. The discussion of liposomal amphotericin B cites studies only as recent as 1992 and informs the reader that there is a lack of controlled studies of its antifungal effect. The discussion of chronic renal failure attributable to lithium is, in my opinion, too conservative in not ascribing some chronic diseases to the effects of lithium. However, no references later than 1987 are cited in this regard, and the results of more recent, prospective studies are not mentioned.

What else might a reader desire? An initial chapter describing which patients with renal disease to consider as potential victims of nephrotoxic agents and a systematic approach to such patients would have linked all the subsequent, agent-specific chapters. A more detailed discussion of the epidemiology of renal disease caused by nephrotoxins and a comparison with other causes of renal failure would have been valuable. The index -- a paltry three pages long -- is no more helpful than the table of contents and should have been markedly expanded. A minor but annoying detail is the use of numbered subheadings throughout the text, which make the book read like a legal document.

The typical practicing nephrologist usually consults the latest version of a general nephrology textbook for discussions of clinical nephrotoxins. This book is most appropriate for reference libraries where scholarship is as appreciated as timeliness.

Reviewed by Mark S. Paller, M.D.
Copyright © 1998 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Product Details

• Hardcover: 528 pages
• Publisher: Springer; 1 edition (February 28, 1998)
• Language: English
• ISBN-10: 0792336119
• ISBN-13: 978-0792336112
• Product Dimensions: 10.8 x 8.2 x 1.2 inches
• Shipping Weight: 3 pounds (View shipping rates and policies)
• Amazon Best Sellers Rank: #9,312,797 in Books (See Top 100 in Books)