What is it about?
Acute kidney injury (AKI) is a severe, life-threatening decline in kidney function that frequently occurs as an unintended side effect of everyday and specialized medications. This comprehensive review examines the main cellular pathways and underlying mechanisms through which commonly prescribed therapeutic agents—including non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, anticancer drugs, immunosuppressants, and antifungals—cause kidney toxicity. It explores how drug-induced nephrotoxicity manifests through crystal formation, oxidative stress, reduced renal blood flow, direct cell damage, and microvascular blockage. Furthermore, the article evaluates early diagnostic biomarkers that enable timely detection of kidney damage before irreversible harm occurs, alongside protective therapeutic strategies and natural/drug-based antioxidant interventions that can mitigate or prevent renal damage.
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Why is it important?
Drug-induced nephrotoxicity is a major contributor to hospital-acquired acute kidney injury, resulting in elevated morbidity, prolonged hospitalizations, and increased mortality rates worldwide. By systematically mapping out the specific cellular mechanisms associated with distinct drug classes and highlighting novel, sensitive biomarkers, this review provides clinicians and researchers with actionable insights. Improving early detection and adopting targeted protective strategies will help clinicians optimize patient drug regimens, prevent drug-induced renal failure, reduce healthcare costs, and ultimately save lives.
Perspectives
Kidney damage caused by indispensable drugs—such as chemotherapy agents or critical antibiotics—presents a major clinical dilemma: balancing therapeutic benefit against organ toxicity. Our goal with this review was to bridge the gap between bench research and bedside practice by consolidating current knowledge on drug-specific toxic pathways, novel early-warning biomarkers, and protective co-therapies. We hope this work inspires safer drug design, early intervention protocols, and more personalized patient management strategies in clinical settings.
KHUSH JAIN
Read the Original
This page is a summary of: Drug-Induced Acute Kidney Injury: Mechanisms, Biomarkers, and Therapeutic Strategies, Current Drug Safety, July 2025, Bentham Science Publishers,
DOI: 10.2174/0115748863362596250627155607.
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