Renal Toxicity

Biomarkers of acute renal toxicity in humans

Project Grant ID: NHMRC 1011772
Principal Investigator: Prof. Nick Buckley, University of New South Wales

There are many serious toxicological population health issues in the developing countries of the region. Sri Lanka has a major problem with deliberate self-poisoning, with at one time the highest total and youth suicide rates in the world. Both primary prevention and improved medical management could rapidly reduce deaths. However, there is little activity on either front.

There are number of clinical toxicological situations where acute renal injury is very common and apparent with current tests and a number where it is less apparent but we have good reason to suspect sub-clinical toxicity is much more common. The standard biomarkers for renal injury are creatinine, urea and urinalysis.  These are not very sensitive, delayed and non-specific particularly with respect to the site of injury.

Many people have proposed using new biomarkers that directly measure kidney injury rather than function. These new biomarkers include urinary KIM-1, Albumin, Total Protein, beta2-Microglobulin, Cystatin C, Clusterin, Trefoil factor-3, NAG, NGAL and IL-18.  All have received significant support in the literature as being potentially superior biomarkers for nephrotoxicity in humans.

There is currently no research assessing long term renal outcomes of acute toxic renal injury in humans using these biomarkers. We propose to review and investigate the new and established renal biomarkers.