Urinalysis to exclude and monitor nephrotoxicity

A large number of compounds, which are in common usage in industry and medi cine, are potentially nephrotoxic. Renal damage and disease resulting from toxic exposure is progressive and will, if unarrested, culminate in irrever sible renal disease. There is, therefore, a need to develop a battery of te sts with which to monitor and characterise the nephrotoxic cascade. A Europ ean-wide study compared biomarker profiles of adult male workers who were e xposed to heavy metals or solvents. It became apparent that the urinary pro files varied with the nature of the toxin. reflecting the functional region of the kidney affected and also the severity of the damage. Children are a particularly vulnerable group and the investigation of range of biomarkers indicated that they were indeed susceptible to nephrotoxic pollutants in t heir environment. It is proposed that a small cohort of tests should be use d to monitor the early (pre-clinical stages) of renal damage or dysfunction : these can be supplemented if necessary by additional specific tests. In t he future better information on at-risk populations and genetic information will enable the determination of individual susceptibility to be assessed more precisely. (C) 2000 Elsevier Science B.V. All rights reserved.