4. How to detect toxic kidney damage

Markers of renal toxicity are :

• increase in serum creatinine;

• glomerular damage, characterized by the presence of high molecular weight proteins (greater than 68,000 daltons) in the urine; albumin is a marker of high molecular weight proteinuria (albuminuria);

• Severe glomerular disease, characterized by the presence of red blood cells in the urine; blood in the urine (hematuria) is a marker of severe disease;

• proximal tubal damage is characterized by the presence of low-molecular-weight proteins (less than 68,000 daltons) in the urine; retino transport protein (RBP) is a marker of low-molecular-weight proteinuria;

• distal tubular disease, characterized by excessive uromodulin (Tamm Horsfall protein) in the...