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Molecular Mechanisms of Nephrotoxicity: From Environmental Toxins to Therapeutic Agents

A Special Issue of International Journal of Molecular Sciences (ISSN 1422-0067) belonging to the section "Molecular Toxicology".

Deadline for manuscript submissions: 20 October 2026 | Viewed by 2273

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Special Issue Information

Dear Colleagues,

Kidney injury remains a major health concern worldwide, with environmental toxins and therapeutic agents both recognized as critical contributors to nephrotoxicity. Increasing evidence demonstrates that exposure to pesticides, emerging pollutants, and environmental toxicants can disrupt renal cellular homeostasis, leading to oxidative stress, DNA damage, inflammation, and cell death. These mechanisms are closely associated with the initiation and progression of acute kidney injury and chronic kidney disease.

At the same time, therapeutic agents, although indispensable in modern medicine, may also induce nephrotoxic effects through complex molecular pathways, highlighting the urgent need to balance efficacy and safety in clinical practice. Recent advances in nephrology and toxicology have begun to clarify the interplay between toxicant exposure, renal pathophysiology, and protective therapeutic strategies.

This Special Issue will explore the molecular mechanisms of nephrotoxicity, ranging from environmental toxins to therapeutic interventions. We welcome studies that investigate the underlying pathways, biomarkers, and translational approaches, as well as research aiming to identify novel therapeutic strategies for prevention or treatment. By integrating insights from toxicology, nephrology, and public health, this Special Issue will broaden our understanding and foster innovative solutions to mitigate nephrotoxic risks.

Prof. Dr. Chih-Kang Chiang
Guest Editor

Manuscript Submission Information

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Keywords

  • pesticides
  • emerging pollutants
  • environmental toxicants
  • therapeutic strategies
  • nephrology
  • toxicology
  • public health

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Published Papers (2 papers)

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Review

27 pages, 3230 KB  
Review
The Need for Omics Studies in Chronic Kidney Disease of Unknown Etiology (CKDu): A Narrative Review and Perspective
by Carly S. Chesterman, Amy S. Li, Chi-Yun Chen, Matthew Gibb, Richard J. Johnson, Zhoumeng Lin and Jared M. Brown
Int. J. Mol. Sci. 2026, 27(13), 5766; https://doi.org/10.3390/ijms27135766 - 26 Jun 2026
Viewed by 700
Abstract
Chronic Kidney Disease of Unknown Etiology (CKDu) is an ongoing global health concern, particularly affecting agricultural communities in equatorial regions. Unlike traditional chronic kidney disease (CKD), CKDu occurs without common risk factors such as diabetes, hypertension, or kidney stones. Its etiology remains poorly [...] Read more.
Chronic Kidney Disease of Unknown Etiology (CKDu) is an ongoing global health concern, particularly affecting agricultural communities in equatorial regions. Unlike traditional chronic kidney disease (CKD), CKDu occurs without common risk factors such as diabetes, hypertension, or kidney stones. Its etiology remains poorly understood, with environmental exposures, occupational hazards, and genetic susceptibility proposed as contributing factors. Omic technologies including genomics, transcriptomics, proteomics, metabolomics, and exposomics offer promising avenues to elucidate CKDu pathogenesis by enabling comprehensive molecular profiling and identification of biomarkers. Recent genomic studies have explored single nucleotide polymorphisms (SNPs) linked to kidney injury susceptibility, while transcriptomic analyses have identified differential expression of genes involved in oxidative stress and tubular injury pathways. Proteomic investigations have revealed candidate urinary biomarkers such as heat shock proteins and inflammatory mediators, and metabolomic profiling has highlighted alterations in amino acid and energy metabolism in affected individuals. Exposomic approaches are beginning to characterize cumulative chemical exposures, including pesticides and heavy metals, in endemic regions. This narrative review synthesizes current evidence on the application of omics approaches in CKDu research, highlights knowledge gaps, and proposes future directions for integrating multi-omics studies with machine learning and artificial intelligence approaches. Advancing omics-based investigations may provide critical insights into disease mechanisms, improve diagnostic precision, and inform targeted interventions for vulnerable populations. Full article
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24 pages, 880 KB  
Review
Evidence-Based Assessment of Pesticide-Related Nephrotoxicity: Clinical Outcomes, Experimental Data, and Molecular Signatures
by Hsin-Yi Lu, Yung Chang and Chih-Kang Chiang
Int. J. Mol. Sci. 2026, 27(9), 3970; https://doi.org/10.3390/ijms27093970 - 29 Apr 2026
Cited by 1 | Viewed by 1134
Abstract
Pesticide exposure is a plausible but incompletely characterized contributor to kidney injury. This review integrates current clinical, epidemiologic, experimental, and mechanistic evidence on pesticide-related nephrotoxicity, focusing on glyphosate-based herbicides, paraquat, organophosphate insecticides, and atrazine. A structured search of PubMed and Web of Science [...] Read more.
Pesticide exposure is a plausible but incompletely characterized contributor to kidney injury. This review integrates current clinical, epidemiologic, experimental, and mechanistic evidence on pesticide-related nephrotoxicity, focusing on glyphosate-based herbicides, paraquat, organophosphate insecticides, and atrazine. A structured search of PubMed and Web of Science identified English-language studies published between January 2015 and February 2026. Of 635 records screened, 61 human studies were retained for full-text evaluation, and relevant animal, in vitro, and regulatory sources were additionally reviewed for mechanistic interpretation. Across pesticide classes, the proximal tubule emerged as the most consistent renal target, although downstream pathways differed, including oxidative stress, mitochondrial dysfunction, transporter disruption, endoplasmic reticulum stress, inflammation, apoptosis, ferroptotic signaling, and fibrotic remodeling. Human evidence was strongest for acute kidney injury following severe poisoning, whereas associations between chronic occupational or environmental exposure and chronic kidney disease or end-stage renal disease were more limited and heterogeneous. Biomarkers including kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), β2-microglobulin, cystatin C, interleukin-18 (IL-18), cytochrome c, and 8-hydroxy-2′-deoxyguanosine (8-OHdG) often detected early tubular stress before abnormalities appeared in conventional renal indices. Overall, pesticide nephrotoxicity is best conceptualized as a spectrum of mechanism-specific tubular injury signatures, supporting a shift toward biomarker-informed early detection, improved hazard identification, and more mechanistically grounded risk assessment. Full article
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