DRUGS & KIDNEY
Dr. Kishore Dharan, Dr. Babu Francis, Dr. Jose P. Paul, Dr. Binu Upendran
The idea of the session was to go through the effects of some
commonly used drugs on the kidney, in which class of patients special
precautions must be taken and ways to minimize renal side effects of these
drugs. Dr. Kishore Dharan spoke on radio contrast nephropathy, where elderly
people, people with pre-existing renal failure and diabetic nephropathy were
prone for developing complications. The simple way to minimize complications was
to hydrate the patients well prior to contrast administration, especially with
saline loading. Dr. Babu Francis spoke on NSAID renal toxicity in elderly
patients, and patients with pre-existing renal failure were specially prone for
NSAID nephrotoxicity. Therefore it is better to avoid NSAIDS in these
populations. Dr. Jose spoke on ways to minimize aminoglycoside
nephrotoxicity – i.e. to monitor S. creatinine once in every 3 days, using once daily doses of aminoglycosides, and to restrict its use to less than 7 days at a time.
Dr. Binu Upendran spoke on ACEI & ARBs – to recognize population prone for ACEI/ ARB nephrotoxicity is to monitor S. creatinine and S. kt within one week after starting ACEI/ARB – if there is a rise in S.Creat >25% from baseline to stop ACEI/ARB.