Concessao Preethi Lavina, Prakash Jay
Department of Basic Medical Sciences, Division of Physiology, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Vet World. 2025 Jul;18(7):2136-2157. doi: 10.14202/vetworld.2025.2136-2157. Epub 2025 Jul 30.
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.
砷暴露仍然是一个严重的全球健康问题，越来越多的证据表明它与严重的肾功能障碍有关。本综述探讨了砷诱导肾毒性的潜在机制，包括氧化应激、线粒体功能障碍、炎症和程序性细胞死亡，这些共同导致肾小球和肾小管的损伤。长期暴露与蛋白尿、肾功能损害以及慢性肾脏病（CKD）风险增加有关。新兴生物标志物如β2-微球蛋白、肾损伤分子-1和中性粒细胞明胶酶相关脂质运载蛋白，在比血清肌酐等传统标志物更早且更具特异性地检测砷相关肾损伤方面显示出前景。预防策略，如先进的水净化系统以及用维生素C、硒和姜黄素等进行抗氧化剂补充，再加上针对砷监测和监管的公共卫生政策，对于降低暴露风险至关重要。持续开展诊断和治疗创新研究对于减轻砷诱导的肾脏疾病负担至关重要。更深入地了解砷的肾毒性途径将支持全球保护肾脏健康的努力，并加强环境卫生倡议。
