药物性肾损伤是儿童急性肾损伤的主要原因之一.药物经由肾脏代谢排泄时导致肾小管上皮细胞损伤、肾脏免疫炎症,或导致肾内血流动力学改变,或形成结晶堵塞肾小管.临床主要表现为急性肾损伤、急性肾小管坏死、急慢性间质性肾炎、结晶性肾病、肾病综合征、肾小管功能障碍等.应用生物标志物可以早期监测药物性肾损伤.临床工作中应及时纠正药物性肾损伤的高危因素,及时停用相关药物和监测肾功能,力求早期诊断,早期干预,改善预后.%Drug-induced kidney injury is one of the main causes of acute kidney injury in children.Certain drugs can lead to tubular epithelial injury,kidney immune inflammation,or alter the intraglomerular hemodynamics,or cause intrarenal obstruction,which contribute to clinical manifestations including acute kidney injury,acute tubular necrosis,acute or chronic interstitial nephritis,nephrolithiasis/crystal nephropathy,nephrotic syndrome,tubular dysfunction,et al.The setting of several biomarkers are used for prediction and detection of early drug-induced kidney injury.In clinical practice the risk factors of drug-induced kidney injury should be corrected in time and the related drugs be stopped and kidney function be monitored in order to achieve early diagnosis and early intervention,which can improve the prognosis.
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