[Possibilities of prevention of nephrotoxicity in intensive care unit]. / Mogucnosti prevencije nefrotoksicnog ucinka u intenzivnoj jedinici.

Different nephrotoxic drugs (antibiotic, antifungal, chemotherapeutic, NSAR, cyclosporine) as well as radio contrasts are mainly responsible for impairment of the renal funciton. Some patient populations, like diabetics, older patients and dehydrated patients are in additional risk for kidney failure. The challenge for protection of kidney function is complex, but it is possible in different clinical conditions to influence nephrotoxicity. The prevention of acute renal failure is very important, because this complication is according to many publications a significant risk for mortality. The administration of N acetilcystein, bicarbonate infusion, magnesium infusion, calcium channel blockers are promising strategies. It is very important to stress adequate rehydratation of every single patient, but some patient populations like diabetics, older patients and dehydrated patients are in special risk for nefrotoxicity. Because today radio contrast media are also important reason for nephrotoxicity, the use of low and iso-osmolar contrasts provides additional possibilities for prevention of potential nephrotoxicity.