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Drug-Induced Nephrotoxicity: Pathogenic Mechanisms, Biomarkers and Prevention Strategies
Huizi Wu1,2, Jiaguo Huang3
1Department of Pharmacy, Xiangya Hospital, Central South University, Changsha 410008, China.
Background:
Risk factors of drug-induced nephrotoxicity include drug overdose, drug-drug interactions and drug-related adverse effects. Since the usage of some nephrotoxic drugs is still unavoidable in the clinical setting, understanding the pathogenic mechanisms of their nephrotoxicities is critical to decrease the incidence of kidney injury. Early detection of drug-induced nephrotoxicity and reduction of the therapeutic side effects are realistic approaches to avoid the end stage of renal failure.
Method:
In this review, we summarized the mechanisms and prevention strategies for some drugs that were commonly used clinically and had the possibility of inducing acute and chronic kidney injuries. We discussed the advantages and drawbacks of currently available biomarkers for indicating kidney impairment. In vitro and pre-clinical in vivo models for assessing the nephrotoxicity during the drug developmental stages were also evaluated.
Results:
Nowadays, an increasing number of biomarkers were discovered for the early diagnosis of kidney injury. In addition, various kinds of in vitro and pre-clinical in vivo models were developed and utilized to minimize the potential nephrotoxicity during the drug development.
Conclusion:
The discovery of the early biomarkers and development of accurate diagnostic methods are effective prevention strategies for drug-induced kidney impairment.
Insights
Early detection of drug-induced kidney injury is crucial. New biomarkers and diagnostic methods help prevent renal failure from nephrotoxic medications.
Area of Science:
- Pharmacology
- Nephrology
- Toxicology
Background:
- Drug-induced nephrotoxicity is a significant clinical concern, stemming from overdose, interactions, and adverse effects.
- Understanding pathogenic mechanisms is vital for mitigating kidney injury from unavoidable nephrotoxic drugs.
- Preventing end-stage renal failure requires early detection and management of drug-related side effects.
Purpose of the Study:
- To review mechanisms and prevention strategies for drug-induced acute and chronic kidney injuries.
- To evaluate current biomarkers for kidney impairment and their limitations.
- To assess in vitro and pre-clinical in vivo models for nephrotoxicity assessment during drug development.
Main Methods:
- Literature review of clinical drugs causing kidney injury.
- Analysis of diagnostic biomarkers for kidney impairment.
- Evaluation of preclinical models for nephrotoxicity testing.
Main Results:
- Numerous biomarkers have been identified for early kidney injury diagnosis.
- Advanced in vitro and pre-clinical in vivo models are increasingly used.
- These models aim to minimize potential nephrotoxicity during drug development.
Conclusions:
- Early diagnosis through novel biomarkers is key to preventing drug-induced kidney impairment.
- Development of accurate diagnostic methods enhances prevention strategies.
- Effective management strategies are essential to avoid severe renal outcomes.
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