Renal toxicology

Functional integrity of the kidney is essential as it plays a major role in the excretion of metabolic wastes and regulation of cell volume, electrolyte composition, and acid–base balance. Furthermore, the kidney is one of the major organs responsible for drug biotransformation and excretion. Thus drug-induced toxicity frequently occurs in the kidney. Renal uptake, accumulation, and biotransformation all contribute to susceptibility of kidneys to toxic damage. Due to their secretory functions, the proximal tubule cells are often exposed to higher concentrations of xenobiotics. Moreover, a number of nephrotoxic substances may produce mitochondrial dysfunction, leading to cellular apoptosis or necrosis. Early detection of renal dysfunction using sensitive biomarkers is thus essential for improved clinical outcome. In this chapter, we will focus on (1) the classification of renal toxicants, (2) discuss the biological basis underlying their nephrotoxicity, and (3) the use of site-specific biomarkers for detecting renal toxicity.