Nephrotoxic Acute Renal Dysfunction

Abstract

Patients in intensive care units (ICU) have a variety of complex problems, often with multiple-organ dysfunction, putting them at an exceptionally high risk of adverse drug reactions because of alteration of usual pathways for drug metabolism and excretion. Prescribing for these patients is therefore very difficult since altered drug excretion, impaired metabolism, altered volumes of drug distribution, and drug interactions are problems that need to be overcome to provide safe and effective therapy. Many of these seriously ill patients acquire complications such as nosocomial infection with resultant impaired systemic hemodynamics which further compromises drug metabolism and elimination. Thus, renal failure in the ICU is an adverse prognostic feature for morbidity and mortality, whether it be part of the underlying illness, or acquired due to therapies of those illnesses.