Adverse effects of drugs on the kidney

•Drug reactions offending the kidney are frequent.•Herbal remedies and over-the counter medications are unsuspected offending agents.•Drug misuse is frequent with analgesics, leading to unrecognized adverse consequences.

The number of drugs presently marketed is countless, their prescription is relentlessly growing, such that the likelihood of adverse effects is strikingly increasing. As many drugs are cleared by the body through kidney excretion, renal adverse events are likely. In this review we shall concisely describe the pathophysiologic mechanisms of renal damage by drugs, the different clinical presentations outlining renal toxicity in the course of pharmacologic treatment, and the main offending agents.