Néphrotoxicité et médicaments

Because of the severity of acute renal failure prognosis in the intensive care units, preventive measures must be applied for the use of nephrotoxic agents. No magic bullet exists to prevent drugs related renal dysfunction. Therefore, harmful agents for renal function should be ordered only when significant benefit is expected for the patient. The control for associated risks factors for renal failure, the preservation of renal perfusion and appropriateness of order are simple measures that can be easily applied. The issues of three nephrotoxic agents (i.e. plasma expanders, aminoglycosides, contrast media) frequently used in critically ill patients are discussed.