LAUSR

Recently, Faria and colleagues from Utrecht University published a comprehensive review about the mechanisms of drug-induced kidney injury (Faria et al. 2019). Approximately 25% of serious adverse drug effects are due to druginduced nephrotoxicity (Malyszko and Malyszko 2016; Choudhury and Ahmed 2006). A large fraction of druginduced nephrotoxicity is due to antibiotics. Drug-induced nephrotoxicity can be caused by direct damage to kidney cells or by indirect mechanisms such as crystal deposition or vascular effects (Randjelovic et al. 2017; Gargouri et al. 2018; Jiang et al. 2018). Mechanisms of direct damage to kidney cells are complex, since the kidney contains more than 20 different cell types organized along the glomerulus, proximal tubule, loop of Henle, distal tubule, collecting duct, and capillaries (Lote 2012; Koeppen and Stanton 2013; Reif et al. 2017). Certainly, proximal tubular epithelial cells play a central role and several in vitro tests focus on this cell type (Cheng et al. 2018; Sjögren et al. 2018; Zink 2018). The authors describe mechanisms of nephrotoxicity in relation to kidney anatomy, loss of function, drug transporters in proximal tubule epithelial cells, vascular and tubular injury, crystal neuropathy, and patient-specific risk factors of commonly used nephrotoxic drugs (Faria et al. 2019). Moreover, the review has a strong focus on biomarkers of drug-induced kidney injury and discusses the available models for nephrotoxicity screening. Currently, much research in toxicology focusses on a better understanding of the mechanisms of toxicity of the most relevant organs of drug-induced adverse effects (Leist et al. 2017; Ghallab et al. 2019); besides nephrotoxicity, also liver (Godoy et al. 2009, 2015), heart (Nemade et al. 2018; Chaudhari et al. 2018), lung (Hindman and Ma 2018; Xin et al. 2018), and developmental (Waldmann et al. 2014; Krug et al. 2013) toxicity. The present review of Faria and colleagues is a must read for everyone interested in a comprehensive summary of nephrotoxicity and how this knowledge can be used for in vitro prediction.