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Nephrotoxicity is a significant clinical challenge and global public health issue. Kidney disease progresses over time and is silent due to exposure to nephrotoxicants and oxidative stress. Early detection of kidney injury is crucial for the treatment and nephroprotection. Conventional biomarkers such as blood urea nitrogen (BUN), creatinine, and urea are detected after 60% of kidney injury and they are not specific. The use of specific secondary novel biomarkers for the detection of kidney damage and evaluation of nephrotoxicity is a prerequisite for nephroprotection. Gene expression profiling is a potent technique for decoding pathways involved in nephrotoxicity. Targeting specific genes discovered through gene expression profiling can reduce severity. Nephrotoxicity is associated with the use of drugs such as cisplatin, and gentamycin. Second-generation biomarkers such as kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), clusterin, N-acetyl-β-d-glucosaminidase (NAG), β2-microglobulin, tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) are proteins released from the renal tubules in response to kidney damage and helps in early detection of kidney injury. Evaluation of these novel parameters will help in early diagnosis of kidney injury.
Kalamkar et al. (Sun,) studied this question.