利尿剂相关的肾损害

利尿剂是临床常用药物，广泛应用于利尿消肿、降压和脑水肿等治疗。利尿剂可直接或间接导致肾脏功能和组织学改变。利尿剂可通过细胞外容量的减少、人球和出球小动脉张力的改变和球一管反馈等机制导致肾血流量的减少和肾小球滤过率(GFR)的下降。利尿剂还可引起急性间质性肾炎、肾小管堵塞等肾脏损害；长期使用利尿剂可导致肾结石、尿沉渣异常和低钾性肾病等慢性改变，所以临床医生必须重视和避免利尿剂的肾毒性作用。

Renal lesion associated with diuretics

Diuretics are widely used in clinic practice and also cause several direct as well as indirect functional and anatomic lesions in the kidney.Reduced RBF and/or GFR associated with the administration of diuretics relate to their effects on the TGF feedback mechanism,alternations in afferent or efferent arteriolar tone or development of ECF volume contraction.The diuretics also can result in acute interstitial nephritis,which can lead to chronic renal insufficiency if undetected.In addition,some diuretics can also cause intraductal crystal deposition,nephrolithiasis,hypokalemic nephropathy.So,clinician should pay more attention to avoid the diuretics associated renal lesion although the nephrotoxic effects of diuretics are not very frequent.