What substance is commonly associated with substance-induced acute tubular necrosis?

Acute tubular necrosis (ATN) is a type of kidney injury that can be induced by various substances, and aminoglycosides are a well-established cause of this condition. Aminoglycosides, such as gentamicin and tobramycin, are powerful antibiotics frequently used to treat serious infections caused by Gram-negative bacteria. They are known to cause nephrotoxicity, particularly affecting the renal tubules.

The mechanism behind aminoglycoside-induced ATN involves the accumulation of the drug within renal tubular cells, leading to oxidative stress, cellular injury, and ultimately cell death. This process results in the characteristic histological findings of ATN, including tubular epithelial cell necrosis and casts within the tubular lumen.

In contrast, while other substances like alcohol and nonsteroidal anti-inflammatory drugs (NSAIDs) can impact kidney function and may lead to other forms of kidney injury, they are less specifically associated with ATN compared to aminoglycosides. Alcohol can lead to chronic issues and dehydration, while NSAIDs mainly affect renal hemodynamics and can result in acute kidney injury but do not typically cause ATN directly. ACE inhibitors, on the other hand, are primarily used for hypertension and heart failure and are not directly