Nephrotoxicity of drugs, evaluated by renal enzyme excretion studies

Assessment of renal function and damage in animal species. A review of the current approach of the academic, governmental and industrial institutions represented by the Animal Clinical Chemistry Association

There are a wide variety of laboratory tests available to assess damage to and functional impairment of the kidneys, although the effectiveness of these tests varies greatly depending upon the site specificity of the damage and to a lesser extent upon the animal species involved. Several traditional tests of renal dysfunction and damage, including plasma creatinine and urea, and urinalysis (dipstick and/or quantitative protein), can be used in the first instance to detect nephrotoxicity. A second tier of specific, targetted indicators (concentration test, urinary enzymes, clearance of analytes, specific proteins, etc.) may then be applied to identify further the site of the lesion and the functional status of the kidneys. The glomerular filtration rate (GFR) may be estimated from the clearance of exogenous and endogenous substances. The difficulty in obtaining accurately timed urine samples limits the value of these tests in small animals, although methods that do not involve urine collection are available. The kidney is the origin of several enzymes found in urine that can be used to monitor the toxic effects of chemicals and therapeutic substances. Selective measurement of enzyme activities in urine can be used to detect the site of the renal lesion after traditional tests have established the presence of renal injury. Separation of proteins in urine by electrophoretic techniques may also be used to discriminate damage to different parts of the nephron. Renal cell excretion in urine is a sensitive but unreliable indicator of acute damage to the proximal tubule. The rate of cell excretion is not a good predictor of the severity of tubular injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Nephrotoxicity screening in rats: a validation study

A validation of our non-invasive screening test for the detection of renal damage (Zbinden et al. 1988) is presented. The test is based on repetitive, quantitative urine analysis in groups of six female Sprague-Dawley rats treated on 5 consecutive days with low doses of test substances. Higher doses were administered in the following weeks until nephrotoxic effects or signs of general toxicity were observed. Thirteen reference substances (hexachloro-1:3-butadiene [HCBD], cisplatin, carboplatin, suramin, chloroform, neomycin, rifampicin, phenacetin, phenylbutazone, methicilline, sodium oxalate, ethylene glycol and furosemide) were used. The percentage of rats reaching the test criteria, i.e., pathologic values defined on the basis of measured control values, was determined. In the controls, the overall percentage of rats reaching or exceeding the test criteria was 4.48%, a value that is close to the expected 5%. Evidence of nephrotoxicity was found with all reference compounds. Elevated excretion of cells and occurrence of cylinders were the most sensitive indicators of renal damage. Hematuria was the most frequent finding. Of the other urine constituents measured the enzyme malate dehydrogenase (MDH) was frequently increased. Water consumption, urine volume, pH and specific gravity were occasionally, and protein, glucose, electrolytes, amino acids and gamma-glutamyl-transpeptidase (GGT) were only rarely changed. It is concluded that the screening which is based on quantitative and repeated urine analysis is a useful procedure to detect nephrotoxic chemicals acting by a variety of mechanisms. The histopathological examination of the kidneys contributed useful information of the nature of the toxic effects, but as a screening tool it is less sensitive than quantitative urine analysis.