NEFROTOKSİK VE NEFROPROTEKTİF ETKİLİ BAZI MADDELER

Year 2025, Volume: 16 Issue: 2, 87 - 93, 31.08.2025

Ömer Faruk Karataş , Füsun Temamoğulları

https://doi.org/10.38137/vftd.1603518

Abstract

Böbrekler vücudumuzda toksin atılımı, su ve mineral dengesinin düzenlenmesi, vitamin D, renin, eritropoietin hormonu üretiminde görevli hayati bir organlardır. Böbrekler üzerinde istenmeyen etkiler nefrotoksisite olarak tanımlanmaktadır. Böbrekler için faydalı olan maddeler nefroprotektif maddelerdir. Bu derlemede nefrotoksik etkili bazı ilaçlar (antibiyotikler, antikanser ilaçlar, tiazid işeticileri), mikotoksinler (aflatoksin, okratoksin, patulin), ağır metaller (baryum, cıva, kobalt) anlatılmaktadır. Nefroprotektif bazı maddeler olarak da; bitki orijinli (steveosid, çörek otu, vinkamin, adi kadıntuzluğu, altın kök, safran) ilaç kaynaklı (sodyum glikoz ko-transporter, tolvaptan, ACE inhibitörleri) gibi bazı maddelerle ilgili bilgi verilmiştir.

Keywords

Böbrek , Nefrotoksik , Nefroprotektif

SOME SUBSTANCES WITH NEPHROTOXIC AND NEPHROPROTECTIVE EFFECTS

Abstract

The skin is the largest organ of the human body and acts as a critical barrier, proKidneys are a vital organs in our body responsible for excreting toxins, regulating water and mineral balance, producing vitamin D and renin, erythropoeitin hormone. Undesirable effects on the kidneys are defined as nephrotoxicity. Substances that are beneficial for the kidneys are nephroprotective substances. In this review, Some drugs with nephrotoxic effects (antibiotics, anticancer drugs, thiazide inhibitors), mycotoxins (aflatoxin, ochratoxin, patulin), heavy metals (barium, mercury, cobalt) are described. As some nephroprotective substances; Information is given about some substances such as plant origin (steveoside, black cumin, vincamine, common saltwort, golden root, saffron) and drug origin (sodium glucose co-transporter, tolvaptan, ACE inhibitors).

Keywords

Kidney , Nephroprotectif , Nephrotoxic

References

• Ahmad, S., Amina, H., Aroosha, H., Iskandar, A., Muhammad, S. A., Matheus, F., & Muhammad, U. M. (2019). Quantification of berberine in Berberis vulgaris l. root extract and ıts curative and prophylactic role in cisplatin-ınduced in vivo toxicity and in vitro cytotoxicity. Antioxidants, 8 (6), 185.
• Ajami, M., Shahriar, E., Hamidreza, P., Rouhollah, H., & Soltan, A. E. (2010). Effect of Crocus sativus on gentamicin induced nephrotoxicity. Biological Research 43 (1): 83–90.
• Altuncu, M., & Gıdık, B. (2020). Çörek Otu ( Nigella Sativa L . ) Bitkisinin kullanım alanları ve önemi. çörek otu ( Nigella sativa l. ) bitkisinin kullanım alanları ve önemi. Bayburt Üniversitesi Fen Bilimleri Dergisi, 3(2), 149-53.
• Aoki B. B., Dayana, F., Mônica, T., Ruth, E. S. B., Angélica, B., & Dulce, A. B. (2014). Acute kidney ınjury after contrast-enhanced examination among elderly. Revista Latino-Americana de Enfermagem, 22 (4), 637–44.
• Arslan, M. (2021). Türkiye doğal türlerinden Berberis vulgaris l . (Adi kadın tuzluğu) odununun anatomik yapısı.  Uluslararası Anadolu Ziraat Mühendisliği Bilimleri Dergisi, 3(3), 73-77.
• Benhelima, A., Zohra, K.O, Houari, H., Tarek, B., & Ahmed, A. (2016). Nephroprotective and diuretic effect of Nigella sativa l seeds oil on lithiasic wistar rats. African Journal of Traditional, Complementary and Alternative Medicines, 13 (6), 204–214.
• Bridges, C. C., & Rudolfs, K. Z. (2017). The aging kidney and the nephrotoxic effects of mercury. Journal of Toxicology and Environmental Health - Part B: Critical Reviews, 20 (2), 55–80.
• Cascella, M., Giuseppe, P., Antonio, B., Sabrina, B., Nagoth, J. A., Maria, R. M., Vitale del Vecchio, (2017). Role of Nigella sativa from experimental animal studies. Nutrients, 9 (6), 1–14.
• Dinçel, E., Ayla Ü. A., & Meryem, B. (2018). Bir biyo-tatlandırıcı olarak steavia. Aydın Gastronomy, 2 (2), 1–8. Dong, B. J., (1999). Sulfadiazine-induced crystalluria and renal failure in a patient with AIDS. Journal of the American Board of Family Practice, 12 (3), 243–48.
• Dubourg, L. C., Michoudet, P. Cochat, & G. Baverel. (2001). Human kidney tubules detoxify chloroacetaldehyde, a presumed nephrotoxic metabolite of ıfosfamide. Journal of the American Society of Nephrology, 12 (8), 1615–23.
• Filipski, K., K., Walter J. L., Jaap, V., & Alex S. (2008). Interaction of cisplatin with the human organic cationt ransporter 2, Clinical Cancer Research, 14(12), 3875-3880.
• Gönül, Ş., Ünüvar, S., & Terken B. (2011). Patulin: Its toxicity and possible contamination of products used in baby nutrition. Turk Pediatri Arsivi, 46 (4), 266–70.
• Górriz, J., L., Juan, F. N., Alberto, O., Ander, V., Julio, N., Conxita, J., Alberto, M., & Maria J, S. (2020). Sodium-glucose cotransporter 2 inhibition: Towards an indication to treat diabetic kidney disease. Nephrology Dialysis Transplantation 35, I13–23.
• Hajji, M., Hela, J., Aymen, M., Yassine, B., Nozha, B., Rania, K., Soumaya, B., (2018). Nephrotoxicity of ciprofloxacin: Five cases and a review of the literature. Drug Safety - Case Reports 5 (1), 17.
• Hall, A. M., Bass, P., & Unwin, R. J. (2014). Drug-induced renal Fanconi syndrome. QJM: An International Journal of Medicine, 107(4), 261-269.
• Hou, F. F., & Qiu, G. Z. (2010). Optimal dose of angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker for renoprotection. Nephrology, 15, 57–60.
• Huang, J., Kaipeng, H., Tian, L., Xi, X., Xiaoyan, S., Peiqing, L., & Heqing, H. (2013). Curcumin ameliorates diabetic nephropathy by ınhibiting the activation of the SphK1-S1P signaling pathway. Molecular and Cellular Endocrinology, 365 (2), 231–40.
• Iji, O. T., Temitayo O. A., Oluwaseun O. E., Omolola V. A., Ademola A. O., Moses O. A., Temidayo O. O., Momoh A. Y., Oluwafemi O. O., & Evaristus N., (2023). Ameliorative effects of glycine on cobalt chloride-induced hepato-renal toxicity in rats. Animal Models and Experimental Medicine, 6 (2): 168–77.
• Ishikawa, A. T., Elisa Y. H., Paula L. A. S., Ana P. F. R. L. B., Karina K. M. D., Claudia Y. A., Osamu K., Marcio C. D., & Eiko N. I., (2017). Impact of a Single oral acute dose of aflatoxin b1 on liver function/cytokines and the lymphoproliferative response in C57BL/6 mice. Toxins, 9(11), 374.
• Ji, X, W., Shuang M. J., Xiao R. H., Xiao Z., Rong C., & Wei L. (2018). Influences of renal function descriptors on population pharmacokinetic modeling of Vancomycin in Chinese adult patients. Acta Pharmacologica Sinica, 39(2): 286–93.
• Jivishov, E., Lutfun N., & Satyajit D. S. (2020). Nephroprotective natural products. Annual Reports in Medicinal Chemistry, 55, 251-271.
• Kaya S., Pirinççi İ., Bilgili A. (2007). Metaller ve diğer inorganik maddeler metaller. In, Kaya S, Pirinçci İ, Bilgili A. Editors. Veteriner Hekimliğinde Toksikoloji. 2nd ed. Ankara, Turkey: Medisan Yayınları; 2007. pp. 207–239. 
• Kwiatkowska, E., Leszek D., Violetta D., Anna K., Katarzyna S., & Sebastian K. (2021). The mechanism of drug nephrotoxicity and the methods for preventing kidney damage. International Journal of Molecular Sciences, 22 (11), 6109.
• Liu, C., Arnold B., Sara E. C., Robert S. D., Scott K. F., Rachel J. G., Sheldon L. K., (2011). Clinical practice guidelines by the ınfectious diseases society of america for the treatment of Methicillin-resistant Staphylococcus aureus infections in adults and children: Executive summary. Clinical Infectious Diseases, 52 (3): e18-e55.
• Liu, X., Haiyang F., Zhiyun M., Zhuona W., Ruolan G., Xiaoxia Z., Hui G., & Guifang D. (2023). Combined silver sulfadiazine nanosuspension with thermosensitive hydrogel: an effective antibacterial treatment for wound healing in an animal model. International Journal of Nanomedicine, 679–91.
• Mahadevan, V. (2019). Anatomy of the kidney and ureter. Surgery (United Kingdom), 37 (7), 359–64. Małyszko, J., Klaudia K., Leszek K., & Jacek M. (2017). Nephrotoxicity of anticancer treatment. Nephrology Dialysis Transplantation, 32 (6), 924–936.
• O’Brien, E., Housner, A., & Dietrich, D. R. (2001). Species-, sex-, and cell type-specific effects of Ochratoxin A and B. Toxicological Sciences, 63 (2), 256–264.
• O’Brien, E., and Dietrich D. R. (2004). Mycotoxins affecting the kidney. In, Jerry B. Hook, ‎ Robin S. Goldstein Editors. Toxicology of kidney. 1st ed. New York, USA: Raven Press; 2004. pp.895–936.
• Okada, T., Toshifumi, S., Ikuji, H., Fumie, S., Shigeo, N., Haruhisa, O., Yasuteru, M., Hiroshi, K., & Takashi, S. (2009). Tolvaptan, a selective oral Vasopressin V2 receptor antagonist, ameliorates podocyte injury in puromycin aminonucleoside nephrotic rats. Clinical and Experimental Nephrology, 13 (5), 438–46.
• Orth, S., Michal N., Andrzej W., & Eberhard, R. (1993). Nephroprotective effect of ACE inhibitors. Drugs, 46 (2), 189–96.
• Purswani, M. U., Susan J. E., Harman K. A., & Gary J. N. (2002). Effect of ciprofloxacin on lethal and sublethal challenge with endotoxin and on early cytokine responses in a murine in vivo model. Journal of Antimicrobial Chemotherapy, 50 (1), 51–58.
• Reddy L, Bhoola K. (2010). Ochratoxins-food contaminants: Impact on human health. Toxins, 2(4):771-9.
• Reungjui, S., Thongchai P., Richard, J. J., & Takahiko, N. (2008). Do Thiazides worsen metabolic syndrome and renal disease? The Pivotal roles for hyperuricemia and hypokalemia. Current Opinion in Nephrology and Hypertension, 17 (5), 470–76.
• Rizwan, F., Saquiba Y., Sultana G. B., Ishtiak A. C., Rajibul H., & Tapan, K. C. (2019). Renoprotective effects of stevia (Stevia rebaudiana Bertoni), amlodipine, valsartan, and losartan in gentamycin-induced nephrotoxicity in the rat model: Biochemical, hematological and histological approaches. Toxicology Reports, 6, 683–691.
• Şahin, G. (2021). Tarihsel süreçte safran (Crocus sativus L.) ve safranin günümüzdeki durumu. Uluslararası Anadolu Sosyal Bilimler Dergisi, 5(1), 173-214.
• Shabeer S, Asad S, Jamal A, Ali A. (2022). Aflatoxin contamination, its impact and management strategies: An Updated Review. Toxin, 14 (5), 307.
• Shalaby, Y. M., Esther T. M., Samar S. A., & Azza S. A. (2019). Involvement of Nrf2/HO-1 antioxidant aignaling and NF-ΚB inflammatory response in the potential protective effects of vincamine against methotrexate-induced nephrotoxicity in rats. Archives of Toxicology, 93 (5), 1417–1431.
• Skinner, R., I. M. Sharkey, A. D.J. Pearson, & Craft A. W. (1993). Ifosfamide, mesna, and nephrotoxicity in children. Journal of Clinical Oncology, 11 (1),173–190.
• Su, J. F., Dao P. L., Chun H. L., Jian D. L., & Xiong J. X. (2020). Critical care management of patients with barium poisoning: A case series. Chinese Medical Journal, (6), 724–725.
• Kahyaoğlu, T., D., Özen M. B., & Yıldız, H. (2024). Doğadan gelen şifa: Adaptojenlere genel bir bakış. Bartın Orman Fakültesi Dergisi, 26 (1), 164–171.
• Torres, V. E., Arlene B. C., Olivier D., Ron T. G., Ronald D. P., Lee J., Molly E. H., Alvin E., & Olga S. (2021). Multicenter study of long-term safety of tolvaptan in later-stage autosomal dominant polycystic kidney disease. Clinical Journal of the American Society of Nephrology, 16 (1), 48–58.
• Tursun, A., Türk, E., & Üremiş, I. (2017). Şekerotu (Stevia rebaudiana Bertoni) ve Melisa (Melissa officinalis L.) ‘nın farklı sıcaklık ve CO2 konsantrasyonlarına tepkilerinin araştırılması. Mustafa Kemal Üniversitesi Ziraat Fakültesi Dergisi, 22(2), 49-60.
• Wallace, M. A. (1999). Anatomy and Physiology of the Kidney. AORN Journal, 68(5),799-820.
• Wang, Z. S., Fei G., & Fu E. L. (2013). Effect of Ethanol extract of rhodiola rosea on the early nephropathy in type 2 diabetic rats. Journal of Huazhong University of Science and Technology - Medical Science, 33 (3), 375–378.
• Wijesekara, P. N. K., Wikum, W. K., Jayaweera, A. A. S. J., & Diwan, R. (2017). Review on usage of vancomycin in livestock and humans: maintaining ıts efficacy, prevention of resistance and alternative therapy. Veterinary Sciences, 4 (1), 1–11.
• Wong-B., Annie, J. J., Edmund T., & Paul B. (2011). Vancomycin-associated nephrotoxicity: a critical appraisal of risk with high-dose therapy. International Journal of Antimicrobial Agents, 37 (2), 95–101.
• Yaribeygi, H., Mohammad, T. M., Ramin, R., & Amirhossein, S. (2018). Crocin improves renal function by declining Nox-4, IL-18, and P53 expression levels in an experimental model of diabetic nephropathy. Journal of Cellular Biochemistry, 119 (7), 6080–6093.
• Yilmaz, B. (2023). Diyabetik Nefropatisi Olan Hastalarda Kılavuzlarda Önerilen Nefroprotektif Ajanların Gerçek Yaşamda Kullanım Durumu. Antalya, Turkey, Thesis of PhD, AU, diss.
• Zhang, J., Quan, T., & Shu-F. Z. (2008). Clinical pharmacology of cyclophosphamide and ifosfamide. Current Drug Therapy, 1 (1), 55–84.