Arsenic-induced nephrotoxicity: Mechanisms, biomarkers, and preventive strategies for global health.

Arsenic exposure remains a critical global health concern, with growing evidence linking it to significant kidney dysfunction. This review examines the underlying mechanisms of arsenic-induced nephrotoxicity, including oxidative stress, mitochondrial dysfunction, inflammation, and programmed cell death, which collectively contribute to damage in the glomeruli and renal tubules. Chronic exposure is associated with proteinuria, renal impairment, and an increased risk of chronic kidney disease (CKD). Emerging biomarkers such as β2-microglobulin, kidney injury molecule-1, and neutrophil gelatinase-associated lipocalin have shown promise in detecting arsenic-related renal damage earlier and with greater specificity than traditional markers like serum creatinine. Preventive strategies - such as advanced water purification systems and antioxidant supplementation with agents such as vitamin C, selenium, and curcumin - alongside public health policies targeting arsenic monitoring and regulation, are essential to mitigate exposure risks. Continued research into diagnostic and therapeutic innovations is crucial for reducing the burden of arsenic-induced kidney disease. A deeper understanding of arsenic's nephrotoxic pathways will support global efforts to protect renal health and strengthen environmental health initiatives.