Toxic and drug damage of the liver and kidneys

Česká verzia

Authors: Teplan V. ^1–4; Ševela K. ⁵
Authors place of work: Klinické a výzkumné centrum pro střevní záněty ISCARE I. V. F. a. s., Praha ¹; 1. LF UK, Praha ²; Subkatedra nefrologie, Institut postgraduálního vzdělávání ve zdravotnictví, Praha ³; Katedra interních oborů a Interní klinika FN a LF OU, Ostrava ⁴; II. interní klinika FN u sv. Anny a LF MU, Brno ⁵
Published in the journal: Gastroent Hepatol 2019; 73(1): 66-75
Category: Chapters from internal medicine: Review Article
doi: https://doi.org/10.14735/amgh201966

Summary

Prevalence of toxic injury with parenchymous organ damage has been growing over recent decades. This could be due poisoning in acute or long-term /follow up. The cause is direct damage or toxoallergic effect. The majority of cases are following oral administration. Therefore, first management should focus on all methods of elimination from the gastrointestinal tract (vomiting, diarrhoea, gastrolavage), by kidneys (forced diuresis), antidotal, and methods of drug elimination by hemoperfusion, hemofiltration, hemodialysis or plasmaferesis. Often there is combined liver and kidney damage. In serious cases the most frequent symptoms are – inhibition of central nervous system (CNS) with cognition disturbance, excitation of CNS, miosis, mydriasis, muscle cramps, cholinergic, anticholinergic symptoms, hyper-and hypoventilation, increased osmotic gap, and metabolic acidosis. Poisoning by methy lalcohol, ethyl alcohol, ethylene glycol, organic solvents, mushrooms, snake and insect toxins and analgesics are frequent. But the most frequent damage is evident after drug administration.

Key words:

nephrotoxicity – hepatotoxicity – elimination – clinical features – treatment

Submitted: 31. 10. 2018

Accepted: 3. 2. 2019

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

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