{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T18:33:36Z","timestamp":1789065216687,"version":"build-2803163510"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Sohag University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pharmacol Toxicol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Acute kidney injury (AKI) is prevalent in critical care, often due to nephrotoxic drug exposure, which accounts for significant morbidity and mortality. Current biomarkers, like serum creatinine, lack sensitivity for early detection of nephrotoxicity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Aim<\/jats:title>\n            <jats:p>This study evaluates proteinuria and serum cystatin C as early indicators of nephrotoxicity in acutely poisoned patients at Sohag University Hospitals.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This prospective study involved 100 acutely poisoned patients with nephrotoxic effects admitted to Sohag University Hospitals from April to August 2021. Inclusion criteria required symptomatic patients who provided at least four blood or urine samples, including one within 24\u00a0h post-ingestion. AKI was classified using the Acute Kidney Injury Network (AKIN) criteria, with baseline serum creatinine estimated from the lowest value during hospitalization. Biomarkers, including serum creatinine and cystatin C, were measured using standard assays for analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The study included 100 patients aged 2 to 58 years, predominantly male (72%). Most participants were from rural areas (82%). Serum creatinine levels significantly increased from day 1 (mean\u2009\u00b1\u2009SD: 1.67\u2009\u00b1\u20090.6\u00a0mg\/dL) to day 2 (mean\u2009\u00b1\u2009SD: 2.98\u2009\u00b1\u20091.35\u00a0mg\/dL). Significant predictors of acute renal toxicity included serum creatinine on both days (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), proteinuria ACR (<jats:italic>P<\/jats:italic>\u2009=\u20090.023), and cystatin C (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Cystatin C had the highest predictive value (AUC\u2009=\u20090.993), while proteinuria ACR and day 2 serum creatinine showed significant predictive capabilities (AUCs of 0.805 and 0.873, respectively).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>In conclusion, proteinuria and cystatin C are reliable predictors for early nephrotoxicity detection in acutely poisoned patients at Sohag University Hospitals. These biomarkers effectively indicate and assess the severity of kidney injury caused by toxicity.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s40360-025-00935-x","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T13:21:45Z","timestamp":1747142505000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Predictive role of cystatin C and increased proteinuria in early assessment of acute renal toxicity in patient poisoned by nephrotoxic drugs and poisons"],"prefix":"10.1186","volume":"26","author":[{"given":"Esam Mohammed Abdallah","family":"Ali","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad Ahmad Mohamad","family":"Yousef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maha Abd El-Hamed","family":"Helal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Hamdi","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3787-2158","authenticated-orcid":false,"given":"Meray Medhat Shokry","family":"Zaghary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwa Ahmed Hasb","family":"Elnabi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"issue":"4","key":"935_CR1","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1016\/j.ccc.2015.06.005","volume":"31","author":"SL Kane-Gill","year":"2015","unstructured":"Kane-Gill SL, Goldstein SL. Drug-induced acute kidney injury: a focus on risk assessment for prevention. Crit Care Clin. 2015;31(4):675\u201384.","journal-title":"Crit Care Clin"},{"issue":"12","key":"935_CR2","doi-asserted-by":"publisher","first-page":"1897","DOI":"10.2215\/CJN.00150118","volume":"13","author":"MA Perazella","year":"2018","unstructured":"Perazella MA. Pharmacology behind common drug nephrotoxicities. Clin J Am Soc Nephrol. 2018;13(12):1897\u2013908.","journal-title":"Clin J Am Soc Nephrol"},{"key":"935_CR3","volume-title":"Critical care nephrology","author":"RA Caires","year":"2019","unstructured":"Caires RA, Silva VT, Burdmann E, Coelho FO, Costalonga EC. Drug-induced acute kidney injury. In: Ronco C, Bellomo R, Kellum JA, Ricci Z, editors. Critical care nephrology. 3rd ed. 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On 15\/09\/2020, the ethical committee approval was obtained for Soh-Med-20-09-15. Data were anonymously collected in the study. The Medical Research Ethics Committee of Sohag Faculty of Medicine, Sohag University, approved the study after written informed consent was obtained from all patients or their first-degree relatives, if appropriate. All of the study\u2019s procedures followed the applicable ethical standards, guidelines, and legislation outlined in the Helsinki Declaration and its subsequent amendments.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"101"}}