Nephrologists warn of kidney failure induced by drugs, medical procedures

As the population with renal damage grows, experts are looking to reduce the risk of this occurring as the result of medical care.

By Victoria Stagg Elliott, AMNews staff. Nov. 26, 2007.

The number of people with kidney disease is increasing, but experts say that not all cases can be blamed on increasing rates of obesity, diabetes and hypertension that are so often cited as likely causes.

The things physicians do as part of patient care also might inadvertently cause damage, and physicians need to be aware of this possibility, according to a session at the Renal Week 2007, the American Society of Nephrology's 40th Annual Meeting and Scientific Exposition in San Francisco last month.

"When you talk about drugs having toxicity, it's very common for that negative effect to be in the kidney," said Glen Markowitz, MD, associate professor of clinical pathology at Columbia University in New York. "We need to educate physicians on recognizing these toxicities."

And some of the newly discovered causes of iatrogenic kidney disease are fairly common parts of medical practice.

For example, Dr. Markowitz presented information on the kidney failure that can result from ingesting oral sodium phosphate solution to prepare the bowels for colonoscopy or surgery. Several studies, including some he wrote, have documented several dozen cases, particularly among older women taking hypertension medications or nonsteroidal anti-inflammatories. The Food and Drug Administration warned of this adverse event last year and called for these preparations not to be used in those at high risk for kidney failure. Ample hydration can help make this complication less likely.