The Nephrotoxicity by Chemicals

The amount of chemicals is constantly increasing, which increases the likelihood of exposure to toxic substances. The kidney is one of the organs most affected by exposure to these chemicals, medications, and environmental pollutants. Although the proximal tubules are the main target of a large majority of nephrotoxic agents, all kidney compartments can be affected by nephrotoxins, leading to one or more classic clinical renal syndromes. These include acute kidney injury, tubulopathies, proteinuric kidney disease, and chronic kidney disease. Different molecular mechanisms, such as oxidative stress, mitochondrial dysfunction, autophagy, necrosis, and apoptosis, can regulate these renal syndromes. It is important to note that the nephrotoxicity of chemicals is not always recognized due to the lack of identification of the causal link between chemicals and kidney damage; however, different clinical biomarkers have been used and discussed in recent years to determine nephrotoxicity at an early stage. This chapter provides an overview of chemicalinduced kidney damage and details about relevant biomarkers for identifying nephrotoxicity. In addition, we discuss some promising therapeutic targets for the early identification of toxin nephrotoxicity.

Keywords: Acute kidney injury, Clinical markers, Chronic kidney injury, Kidney damage, Nephrotoxin, Protein disease, Tubulopathies.