氟喹诺酮类药物肾损害

氟喹诺酮类药物是临床广泛应用的一类抗生素,可通过免疫机制、直接肾毒性及肾小管堵塞等机制,引起肾损害。急性过敏性间质性肾炎是最常报道的病理类型,也可有肾小管坏死及血尿、结晶尿等表现。临床常出现急性肾衰竭。对老年、合并基础肾功能损伤的患者应注意根据不同氟喹诺酮药物代谢途径及肾功能水平进行药物选择及剂量的调整。

Nephrotoxicity of fluoroquinolones:a review.

The fluroquinotones are proving very useful in the management of infection.However,nephrotoxicity associated with fluroquinolone has been reported increasingly,with acute interstitial nephritis(AIN) of most cases.Crystal nephropathy and acute tubular necrosis(ATN) are also reported in some cases.Immune-mediated reaction is supposed to be the main mechanism of fluroquinotones induced nephrotoxicity,together with some reports of direct toxicity of fluroquinotones to proximal tubular cells and obstruction of tubules.Choice of appropriate agent and sometimes dose adjustments may be necessary in senile patients and patients with reduced renal function when using fluroquinotones.