Translational Assessment of Drug‐Induced Proximal Tubule Injury Using a Kidney Microphysiological System

Drug‐induced kidney injury, a major cause of acute kidney injury, results in progressive kidney disease and is linked to increased mortality in hospitalized patients. Primary injury sites of drug‐induced kidney injury are proximal tubules. Clinically, kidney injury molecule‐1, an established tubule‐specific biomarker, is monitored to assess the presence and progression of injury. The ability to accurately predict drug‐related nephrotoxicity preclinically would reduce patient burden and drug attrition rates, yet state‐of‐the‐art in vitro and animal models fail to do so. In this study, we demonstrate the use of kidney injury molecule‐1 measurement in the kidney microphysiological system as a preclinical model for drug toxicity assessment. To show clinical relevance, we use quantitative systems pharmacology computational models for in vitro–in vivo translation of the experimental results and to identify favorable dosing regimens for one of the tested drugs.