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Crystal-induced acute kidney injury (acute renal failure)

Mark A Perazella, MD, FACP
Section Editor
Paul M Palevsky, MD
Deputy Editor
Alice M Sheridan, MD


Crystal-induced acute kidney injury (AKI) is caused by the intratubular precipitation of crystals, which results in obstruction. Crystal-induced AKI most commonly occurs as a result of acute uric acid nephropathy and following the administration of drugs or toxins that are poorly soluble or have metabolites that are poorly soluble in urine [1,2]. Other drugs or medications may be metabolized to insoluble products such as oxalate (ethylene glycol, vitamin C), which are associated with precipitation of calcium oxalate crystals within tubular lumens and kidney injury.

This topic review discusses drug-related crystal-induced AKI. Uric acid nephropathy and acute phosphate nephropathy are discussed elsewhere. (See "Uric acid renal diseases" and "Acute phosphate nephropathy".)


Multiple drugs and toxins cause intratubular crystal-induced obstruction. Common agents include:


Sulfonamide antibiotics

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Literature review current through: Nov 2017. | This topic last updated: Sep 06, 2017.
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