RT Book, Section A1 Schnellmann, Rick G. A2 Klaassen, Curtis D. SR Print(0) ID 1158499380 T1 Toxic Responses of the Kidney T2 Casarett & Doull’s Toxicology: The Basic Science of Poisons, 9th edition YR 2019 FD 2019 PB McGraw-Hill Education PP New York, NY SN 9781259863745 LK accesspharmacy.mhmedical.com/content.aspx?aid=1158499380 RD 2024/03/29 AB The functional integrity of the mammalian kidney is vital to total body homeostasis because the kidney plays a principal role in the excretion of metabolic wastes and in the regulation of extracellular fluid volume, electrolyte composition, and acid–base balance. In addition, the kidney synthesizes and releases hormones such as renin and erythropoietin and metabolizes vitamin D3 to the active 1,25-dihydroxy vitamin D3 form. A toxic insult to the kidney therefore could disrupt any or all of these functions and could have profound effects on total body metabolism. Fortunately, the kidneys are equipped with a variety of detoxification mechanisms and have considerable functional reserve and regenerative capacities. Nonetheless, the nature and severity of the toxic insult may be such that these detoxification and compensatory mechanisms are overwhelmed, and kidney injury ensues. The outcome of renal failure can be profound; permanent renal damage may result, requiring chronic dialysis treatment or kidney transplantation.