药源性肾损伤是指肾脏对治疗剂量药物的不良反应和因药物过量或不合理应用而出现的毒性反应。临床上易导致肾损伤的药物种类很多，包括中药或者化学药的各种剂型和品种，引起肾损伤的常见化学药有抗菌药物、抗肿瘤药物、非甾体抗炎药（NSAIDs）等，具有肾毒性的中药成分有马兜铃酸类、部分生物碱类、蒽醌类等；临床上联合用药也会引起肾损伤。药物引发肾损伤的机制也各有不同，具体包括直接肾小管毒性、肾内血流动力学紊乱、免疫炎症损伤、梗阻性损伤、转运体介导的肾脏蓄积、新型细胞死亡机制的参与等。归纳总结临床上引发肾损伤的常见药物及其损伤机制和预防措施的最新研究进展，为临床上安全合理使用相关药物提供参考。

Drug-induced kidney injury refers to adverse reactions of the kidneys to therapeutic doses of drugs and toxic reactions resulting from drug overdose or inappropriate use. Many types of drugs can easily lead to kidney injury in clinical practice, including various dosage forms and varieties of traditional Chinese medicines or chemical drugs. Common chemical drugs that cause kidney injury include antibacterial drugs, antineoplastic drugs, and nonsteroidal anti-inflammatory drugs (NSAIDs). Traditional Chinese medicine components with nephrotoxicity include aristolochic acids, alkaloids, and anthraquinones. Clinical drug combinations can also cause kidney injury. The mechanisms by which drugs induce kidney injury also vary, specifically including direct tubular toxicity, intrarenal hemodynamic disturbances, immune-inflammatory injury, obstructive injury, transporter-mediated renal accumulation, and the involvement of new cell death mechanisms. This paper summarizes the latest research progress on common drugs that induce kidney injury in clinical practice, as well as their injury mechanisms and preventive measures, to provide a reference for the safe and rational use of related drugs in clinical settings.

R285.5

辽宁省教育厅青年项目（JYTQN2023153）；辽宁省博士科研启动基金（2025-BS-0678）