Table 1.

Mechanisms of cisplatin-induced kidney injury

Mechanisms of cisplatin induced kidney injury	References
Genotoxic stress from covalent cross-linkage DNA purine bases of DNA	[4, 13]
Apoptosis induced by DNA damage from impaired repair	[4, 6, 7, 13, 16]
Production of reactive oxygen species, increasing intracellular oxidative stress	[4, 13, 17, 18]
Disruption of intracellular and mitochondrial calcium homeostasis	[4, 13, 19]
Direct activation of proapoptotic pathways (e.g. JNK)	[8, 20, 21]
Activation of environmental stress pathways (e.g. MAPK)	[4, 9]
Inhibition of carnitine synthesis	[4, 19]
Focal susceptibility from pharmacodynamics (e.g. renal parenchymal accumulation/excretion)	[4, 16, 22–24]

JNK c-Jun N-terminal kinases, MAPK mitogen-activated protein kinase