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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
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Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
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Related Experiment Video

Updated: Apr 21, 2026

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Cell- and biomarker-based assays for predicting nephrotoxicity.

Johnny X Huang1, Mark A Blaskovich, Matthew A Cooper

  • 1The University of Queensland, Institute for Molecular Bioscience , St. Lucia, Brisbane, QLD 4072 , Australia.

Expert Opinion on Drug Metabolism & Toxicology
|November 11, 2014
PubMed
Summary

Accurately predicting drug-induced nephrotoxicity remains challenging. Novel kidney-on-a-chip and 3D culture systems show promise for improved in vitro prediction of kidney injury during drug development.

Keywords:
adverse drug reactionbiomarkercell-based assaydrug discoverykidneynephrotoxicityrenal failurescreeningthree-dimensional culture

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Area of Science:

  • Nephrology
  • Toxicology
  • Drug Discovery

Background:

  • Drug-induced nephrotoxicity is a major cause of investigational drug failure.
  • Current methods lack accuracy in predicting kidney toxicity early in drug development.

Purpose of the Study:

  • To review traditional and emerging kidney injury biomarkers for nephrotoxicity determination.
  • To evaluate the potential of in vivo biomarkers in high-throughput in vitro screening.
  • To compare cell types and novel 3D culture technologies for in vitro nephrotoxicity prediction.

Main Methods:

  • Review of existing literature on kidney injury biomarkers.
  • Discussion of in vitro screening assays and cell culture technologies.
  • Comparison of traditional cell culture with novel 3D and 'kidney-on-a-chip' systems.

Main Results:

  • Traditional in vitro assays show poor correlation with in vivo nephrotoxicity results.
  • Validated renal biomarkers show potential for early in vivo detection but not yet for in vitro prediction.
  • Novel 3D and 'kidney-on-a-chip' technologies offer improved predictive capabilities.

Conclusions:

  • There is an urgent need for better in vitro systems to predict drug-induced nephrotoxicity.
  • Advanced culture technologies like 'kidney-on-a-chip' and 3D cultures show promise for accurate prediction.
  • These novel systems can generate biomarker signatures from relevant kidney cells for improved drug safety assessment.