Top Ten Drugs That Cause Kidney Damage

Top Ten Drugs That Cause Kidney Damage

Drugs can cause acute renal injury, intrarenal obstruction, interstitial nephritis, nephrotic syndrome, and acid-base and fluid electrolytes disorders. Certain drugs can cause alteration in intraglomerular hemodynamics, inflammatory changes in renal tubular cells, leading to acute kidney injury and renal scarring.

Medications are a relatively common cause of acute kidney injury, especially in hospitalized patients who are exposed to numerous agents. Drug-related acute tubular/tubulointerstitial injury is the most common cause of AKI associated with these agents. The toxic effects of drugs and their renal handling often lead to various forms of AKI.

Prospective cohort studies of AKI have documented the frequency of drug-induced nephrotoxicity to be approximately 14-26% in adult populations. Nephrotoxicity is also a significant concern in pediatrics with 16% of hospitalized AKI events being attributable primarily to a drug . 

What are the top 10 drugs that cause kidney damage?

There are several drugs that can cause liver damage from over the counter medication to prescription medicines. The table below provides a full list of all medications that can damage your kidney:


Acetaminophen, aspirinChronic interstitial nephritis

Nonsteroidal anti-inflammatory drugsAcute interstitial nephritis, altered intraglomerular hemodynamics, chronic interstitial nephritis, glomerulonephritis
Antidepressants/mood stabilizers

Amitriptyline (Elavil*), doxepin (Zonalon), fluoxetine (Prozac)Rhabdomyolysis

LithiumChronic interstitial nephritis, glomerulonephritis, rhabdomyolysis

Diphenhydramine (Benadryl), doxylamine (Unisom)Rhabdomyolysis

Acyclovir (Zovirax)Acute interstitial nephritis, crystal nephropathy

AminoglycosidesTubular cell toxicity

Amphotericin B (Fungizone*; deoxycholic acid formulation more so than the lipid formulation)Tubular cell toxicity

Beta lactams (penicillins, cephalosporins)Acute interstitial nephritis, glomerulonephritis (ampicillin, penicillin)

Foscarnet (Foscavir)Crystal nephropathy, tubular cell toxicity

Ganciclovir (Cytovene)Crystal nephropathy

Pentamidine (Pentam)Tubular cell toxicity

QuinolonesAcute interstitial nephritis, crystal nephropathy (ciprofloxacin [Cipro])

Rifampin (Rifadin)Acute interstitial nephritis

SulfonamidesAcute interstitial nephritis, crystal nephropathy

Vancomycin (Vancocin)Acute interstitial nephritis

Adefovir (Hepsera), cidofovir (Vistide), tenofovir (Viread)Tubular cell toxicity

Indinavir (Crixivan)Acute interstitial nephritis, crystal nephropathy
Calcineurin inhibitors

Cyclosporine (Neoral)Altered intraglomerular hemodynamics, chronic interstitial nephritis, thrombotic microangiopathy

Tacrolimus (Prograf)Altered intraglomerular hemodynamics
Cardiovascular agents

Angiotensin-converting enzyme inhibitors, angiotensin receptor blockersAltered intraglomerular hemodynamics

Clopidogrel (Plavix), ticlopidine (Ticlid)Thrombotic microangiopathy


Carmustine (Gliadel), semustine (investigational)Chronic interstitial nephritis

Cisplatin (Platinol)Chronic interstitial nephritis, tubular cell toxicity

Interferon-alfa (Intron A)Glomerulonephritis

MethotrexateCrystal nephropathy

Mitomycin-C (Mutamycin)Thrombotic microangiopathy
Contrast dyeTubular cell toxicity

Loops, thiazidesAcute interstitial nephritis

Triamterene (Dyrenium)Crystal nephropathy
Drugs of abuse

Cocaine, heroin, ketamine (Ketalar), methadone, methamphetamineRhabdomyolysis

Chinese herbals with aristocholic acidChronic interstitial nephritis
Proton pump inhibitors

Lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix)Acute interstitial nephritis

Allopurinol (Zyloprim)Acute interstitial nephritis

Gold therapyGlomerulonephritis

Haloperidol (Haldol)Rhabdomyolysis

Pamidronate (Aredia)Glomerulonephritis

Phenytoin (Dilantin)Acute interstitial nephritis

Quinine (Qualaquin)Thrombotic microangiopathy

Ranitidine (Zantac)Acute interstitial nephritis

Zoledronate (Zometa)Tubular cell toxicity

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