Kidney disorders
are increasing with fast pace and emerged as major health challenge in recent
decades. It has been emphasised in various studies published in reputed
journals to take serious preventive measures about alarming situation of
prevalence of kidney diseases leading to acute or chronic renal failure, (ESRD)
end stage renal disease thereby resulting in kidney transplantation. The
epidemiological evidence at present indicates that nephrotoxicity leading to
acute and chronic renal failure has a substantial financial burden on the
society.
Being the main
organ of excretion for many endogenous metabolites and waste products, and also
various exogenous substances like chemicals and drugs that are used to treat
different ailments of the body, kidney always remains in contact with
substances of aversive nature. This makes the kidney vulnerable to toxicity and
injury. Secondly, the effect of occupational or therapeutic exposure to metals
on kidney is well established; furthermore, a number of drugs which are
frequently used in the management of various diseases cause significant degree
of nephrotoxicity even at normal therapeutic dose levels. There are several
chemicals which cause such nephropathies, which remain unrecognized for quite
some time. These include toxicities caused by cadmium and other heavy metals,
anti cancer drugs, cyclosporins, analgesics, antibiotics etc. and
recently reported nephropathies caused by plant drugs containing aristolochic
acid.
The specific physiologic characteristics of kidney are
localized to specific cell types, which further makes it susceptible to and
targets for chemicals. Furthermore, kidney remains under tremendous pressure to
maintain the homeostasis of the body in several pathophysiological conditions
like edema, obesity, CHF and other diseases that adversely affect the kidney
function and produce oxidative changes leading to cellular injury. The nephron,
that performs a variety of physiological functions; also bioconverts chemicals
and metabolically activates a variety of compounds. Not with standing there is
a substantial capacity within the kidney for repair, but there are also several
circumstances where damage may be irreversible.
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