Cyclophosphamide-induced nephrotoxicity: a mini-review

Cyclophosphamide (CP) is a widely used alkylating chemotherapeutic and immunosuppressive drug for treating malignancies, autoimmune disorders, and renal diseases. However, its clinical use is limited by nephrotoxicity caused by toxic metabolites such as phosphoramide mustard and acrolein. These metabolites induce oxidative stress, inflammation, mitochondrial dysfunction, and apoptosis in renal tissues. CP administration results in elevated renal biomarkers including serum creatinine, blood urea nitrogen, cystatin-C, KIM-1, and NGAL, along with severe histopathological damage. Activation of inflammatory cytokines and NF-κB pathways further aggravates renal injury. Various antioxidants and pharmacological agents have shown potential renoprotective effects.