La Néphrotoxicité Médicamenteuse

Abstract

Drug-induced nephrotoxicity, defined as any renal injury caused by a medicinal treatment, represents a major public health concern that, despite its frequency and severity, remains insufficiently documented and explored in Algeria. It is within this context of scarce scientific data that this work is grounded, with the objective of describing the reality of this phenomenon and assessing the role of the clinical pharmacist in its prevention. To meet this objective, a descriptive cross-sectional survey was conducted among 37 nephrologists practicing in Algeria. The results reveal that NSAIDs, led by diclofenac, along with antibiotics, dominated by gentamicin, represent the most frequently implicated drug classes. These findings emerge against a worrying backdrop of widespread self-medication, which daily exposes vulnerable patients to a preventable form of renal iatrogenesis. This vulnerability is further heightened by the fact that toxicity occurs preferentially in patients already weakened by pre-existing chronic kidney disease, dehydration, or diabetes, thereby reinforcing the urgency of early detection. Yet, the biomarkers enabling such detection remain inaccessible in the majority of healthcare facilities, leaving diagnosis dependent on late and insufficient markers. In light of these findings, the role of the clinical pharmacist emerges as an indispensable response, particularly given that 76% of nephrology departments still lack one, while 89% of the nephrologists surveyed express support for their systematic integration. This study therefore advocates for stricter regulation of NSAID sales, the establishment of a national pharmacovigilance registry for drug-induced renal injuries, and the effective integration of the clinical pharmacist as a cornerstone of therapeutic safety in hospital settings.