Which medication class is a common nephrotoxin contributing to ATN?

Which medication class is a common nephrotoxin contributing to ATN?

• A. Aminoglycoside antibiotics
• B. Penicillin
• C. ACE inhibitors
• D. Loop diuretics

Answer: (A)

Aminoglycoside antibiotics are a classic nephrotoxin that contributes to acute tubular necrosis by causing direct injury to proximal tubular epithelial cells. They are filtered by the glomerulus and taken up in large amounts by these cells, accumulating in lysosomes and triggering cellular injury and necrosis. This pattern defines intrinsic AKI from a toxin, often with a rising creatinine and granular (muddy brown) casts on urinalysis. Other medications can cause kidney injury too, but they tend to produce different patterns: penicillins more commonly cause acute interstitial nephritis; ACE inhibitors can precipitate AKI via hemodynamic changes in certain settings (like volume depletion or renal artery stenosis); loop diuretics can lead to volume depletion and prerenal azotemia rather than primary tubular necrosis.

Aminoglycoside antibiotics are a classic nephrotoxin that contributes to acute tubular necrosis by causing direct injury to proximal tubular epithelial cells. They are filtered by the glomerulus and taken up in large amounts by these cells, accumulating in lysosomes and triggering cellular injury and necrosis. This pattern defines intrinsic AKI from a toxin, often with a rising creatinine and granular (muddy brown) casts on urinalysis. Other medications can cause kidney injury too, but they tend to produce different patterns: penicillins more commonly cause acute interstitial nephritis; ACE inhibitors can precipitate AKI via hemodynamic changes in certain settings (like volume depletion or renal artery stenosis); loop diuretics can lead to volume depletion and prerenal azotemia rather than primary tubular necrosis.