Drug and herbal medicine-induced nephrotoxicity in children; review of the mechanisms

Abstract

Acute renal failure (ARF) in children can be induced by different chemical and herbal medications. Different drugs mainly antimicrobials, chemotherapeutic agents, and nonsteroidal anti-inflammatory drugs (NSAIDs) have all been shown to be involved in druginduced renal injury in pediatrics. In addition, the nephrotoxic effects of some medical plants particularly in children have been proven, despite the beneficial features. This review aimed to describe how different drugs could induce nephrotoxicity in pediatric population. We searched the current medical literature through different search databases such as PubMed, Scopus, EMBASE, Cochrane central register of controlled trials, EBSCO, and Google Scholar. The results of this study proved that herbal and chemical drugs induce nephrotoxicity in children by different mechanisms. Their toxicity mainly is related to the necrosis and apoptosis induced by these agents or their derivatives in the renal proximal tubular cells. Due to the importance of using these drugs for life-threatening illness in children, new strategies such as co-administration with other agents or developing new formulations are suggested to be investigated.