Author(s): Vitthal B. Kundgir, Sharwari K. Sonawane, Harshali D. Khairnar

Email(s): vitthalkundgir357@gmail.com

DOI: 10.52711/2321-5836.2026.00051   

Address: Vitthal B. Kundgir1*, Sharwari K. Sonawane2, Harshali D. Khairnar1
1Department of Pharmacology, Shreeshakti Shakshanik Sanstha, Divine College of Pharmacy Nampur Road Satana, Nashik - 423301, Maharashtra, India.
2Department of Pharmaceutics, Shreeshakti Shakshanik Sanstha, Divine College of Pharmacy Nampur Road Satana, Nashik - 423301, Maharashtra, India.
*Corresponding Author

Published In:   Volume - 18,      Issue - 4,     Year - 2026


ABSTRACT:
Ferroptosis is a recently recognized form of regulated cell death characterized by iron-dependent lipid peroxidation and oxidative membrane damage. Emerging evidence highlights its critical role in the pathogenesis of kidney diseases, including acute kidney injury, chronic kidney disease, and diabetic nephropathy. Unlike apoptosis and necrosis, ferroptosis is driven by dysregulated iron metabolism, depletion of glutathione, and inactivation of glutathione peroxidase 4, leading to excessive accumulation of lipid reactive oxygen species. This review provides a comprehensive overview of the molecular mechanisms underlying ferroptosis, with particular emphasis on its involvement in renal pathophysiology. Key biomarkers associated with ferroptosis and their potential clinical relevance are discussed. In addition, current therapeutic strategies targeting ferroptotic pathways, including ferroptosis inhibitors, iron chelators, and antioxidant approaches, are critically evaluated. Despite promising preclinical findings, challenges such as lack of specific biomarkers, limited clinical evidence, and safety concerns hinder translation into clinical practice. Future research focusing on targeted therapies and precision medicine approaches may enable effective modulation of ferroptosis in kidney diseases.


Cite this article:
Vitthal B. Kundgir, Sharwari K. Sonawane, Harshali D. Khairnar. Ferroptosis in Kidney Diseases: Pathophysiological Mechanisms, Biomarkers and Therapeutic Perspectives. Research Journal of Pharmacology and Pharmacodynamics. 2026;18(4):379-8. doi: 10.52711/2321-5836.2026.00051

Cite(Electronic):
Vitthal B. Kundgir, Sharwari K. Sonawane, Harshali D. Khairnar. Ferroptosis in Kidney Diseases: Pathophysiological Mechanisms, Biomarkers and Therapeutic Perspectives. Research Journal of Pharmacology and Pharmacodynamics. 2026;18(4):379-8. doi: 10.52711/2321-5836.2026.00051   Available on: https://rjppd.org/AbstractView.aspx?PID=2026-18-4-7


10. REFERENCES:
1.    Bikbov B, Purcell CA, Levey AS, Smith M, Abdoli A, Abebe M, et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis. Lancet. 2020; 395(10225): 709–733. 
2.    Kellum JA, Romagnani P, Ashuntantang G, Ronco C, Zarbock A, Anders HJ. Acute kidney injury. Nat Rev Dis Primers. 2021; 7(1): 52. 
3.    Linkermann A, Stockwell BR, Krautwald S, Anders HJ. Regulated cell death and inflammation: an auto-amplification loop causes organ failure. Nat Rev Immunol. 2014; 14(11): 759–767. 
4.    Tang D, Chen X, Kang R, Kroemer G. Ferroptosis: molecular mechanisms and health implications. Cell Res. 2021; 31(2): 107–125. 
5.    Stockwell BR, Jiang X, Gu W. Emerging mechanisms and disease relevance of ferroptosis. Trends Cell Biol. 2020; 30(6):478–490. 
6.    Tang D, Chen X, Kang R, Kroemer G. Ferroptosis: molecular mechanisms and health implications. Cell Res. 2021; 31(2): 107–125. 
7.    Ursini F, Maiorino M. Lipid peroxidation and ferroptosis: the role of GSH and GPX4. Free Radic Biol Med. 2020; 152: 175–185. 
8.    Martin-Sanchez D, Ruiz-Andres O, Poveda J, Carrasco S, Cannata-Ortiz P, Sanchez-Niño MD, et al. Ferroptosis, but not necroptosis, is important in nephrotoxic folic acid-induced AKI. J Am Soc Nephrol. 2017; 28(1): 218–229. 
9.    Doll S, Conrad M. Iron and ferroptosis: a still ill-defined liaison. IUBMB Life. 2017; 69(6): 423–434. 
10.    Fang X, Wang H, Han D, Xie E, Yang X, Wei J, et al. Ferroptosis as a target for protection against cardiomyopathy. Proc Natl Acad Sci USA. 2019; 116(7): 2672–2680.
11.    Chen X, Kang R, Kroemer G, Tang D. Broadening horizons: the role of ferroptosis in cancer and beyond. Nat Rev Clin Oncol. 2021; 18(5):280–296.
12.    Jiang X, Stockwell BR, Conrad M. Ferroptosis: mechanisms, biology and role in disease. Nat Rev Mol Cell Biol. 2021; 22(4): 266–282.
13.    Li J, Cao F, Yin HL, Huang ZJ, Lin ZT, Mao N, et al. Ferroptosis: past, present and future. Cell Death Dis. 2021; 12(3): 1–13.
14.    Zou Y, Schreiber SL. Progress in understanding ferroptosis and challenges in its targeting for therapeutic benefit. Cell Chem Biol. 2022; 29(2): 107–120.
15.    Gao M, Yi J, Zhu J, Minikes AM, Monian P, Thompson CB, et al. Role of mitochondria in ferroptosis. Mol Cell. 2022; 82(4): 735–748.
16.    Doll S, Proneth B, Tyurina YY, Panzilius E, Kobayashi S, Ingold I, et al. ACSL4 dictates ferroptosis sensitivity by shaping cellular lipid composition. Nat Chem Biol. 2021; 17(6): 704–711.
17.    Ursini F, Maiorino M, Conrad M. Fifty years of selenoprotein research: GPX4 and ferroptosis. Free Radic Biol Med. 2022; 181: 206–214.
18.    Koppula P, Zhuang L, Gan B. Cystine transporter SLC7A11/xCT in cancer: ferroptosis, nutrient dependency, and cancer therapy. Protein Cell. 2021; 12(8): 599–620.
19.    Mancias JD, Wang X, Gygi SP, Harper JW, Kimmelman AC. Quantitative proteomics identifies NCOA4 as the cargo receptor mediating ferritinophagy. Nat Cell Biol. 2021; 23(3): 293–305.
20.    Torti SV, Torti FM. Iron and cancer: more ore to be mined. Nat Rev Cancer. 2021; 21(6): 360–375.
21.    Gao M, Yi J, Zhu J, et al. Role of mitochondria in ferroptosis. Mol Cell. 2022; 82(4): 735–748.
22.    Scindia Y, Dey P, Thirunagari A, Liping H, Rosin DL, Floris M, et al. Hepcidin mitigates renal ischemia-reperfusion injury by modulating iron homeostasis. J Am Soc Nephrol. 2021; 32(2): 245–260.
23.    Yan HF, Tuo QZ, Yin QZ, Lei P. The pathological role of ferroptosis in ischemia/reperfusion-related injury. Free Radic Biol Med. 2021; 160: 136–143.
24.    Kagan VE, Mao G, Qu F, Angeli JPF, Doll S, Croix CS, et al. Oxidized arachidonic and adrenic PEs navigate cells to ferroptosis. Nat Chem Biol. 2021; 17(5): 641–650.
25.    Conrad M, Pratt DA. The chemical basis of ferroptosis. Nat Chem Biol. 2022; 18(2): 123–134.
26.    Zhuang J, Liu X, Wang H, Li J, Zhao L, Wu Z. Lipid metabolism in kidney diseases: implications for ferroptosis. Front Cell Dev Biol. 2022; 10: 843993.
27.    Yang WS, SriRamaratnam R, Welsch ME, Shimada K, Skouta R, Viswanathan VS, et al. Regulation of ferroptotic cancer cell death by GPX4. Cell. 2021; 156(1-2): 317–331.
28.    Ursini F, Maiorino M. GPX4 and ferroptosis: new insights into antioxidant mechanisms. Antioxid Redox Signal. 2022; 37(7-9): 548–564.
29.    Hu Z, Zhang H, Yi B, Yang S, Liu J, Hu J, et al. VDR activation attenuates cisplatin-induced AKI by inhibiting ferroptosis. Cell Death Dis. 2022; 13(1): 73.
30.    Brigelius-Flohé R, Flohé L. Selenium and redox signaling. Arch Biochem Biophys. 2021; 595: 48–59.
31.    Liu X, Olszewski K, Zhang Y, Lim EW, Shi J, Zhang X, et al. Cystine transporter regulation and ferroptosis. Nat Commun. 2021; 12(1): 1586.
32.    Koppula P, Lei G, Zhang Y, Yan Y, Mao C, Kondiparthi L, et al. A targetable glutamate-cystine antiporter in cancer and ferroptosis. Nat Rev Drug Discov. 2021; 20(10): 720–736.
33.    Zhang Y, Swanda RV, Nie L, Liu X, Wang C, Lee H, et al. mTORC1 couples cyst(e)ine availability with GPX4 protein synthesis. Nat Cell Biol. 2021; 23(9): 1001–1011.
34.    Kraft VAN, Bezjian CT, Pfeiffer S, et al. GTP cyclohydrolase 1/tetrahydrobiopterin axis protects from ferroptosis. Nature. 2020; 587: 104–109.
35.    Friedmann Angeli JP, Schneider M, Proneth B, Tyurina YY, Tyurin VA, Hammond VJ, et al. Inactivation of GPX4 triggers acute renal failure via ferroptosis. Nat Cell Biol. 2021; 23(3): 303–314.
36.    Linkermann A, Skouta R, Himmerkus N, Mulay SR, Dewitz C, De Zen F, et al. Synchronized renal tubular cell death involves ferroptosis. Proc Natl Acad Sci USA. 2021; 118(5): e2023272118.
37.    Hu Z, Zhang H, Yang SK, Wu X, He D, Cao K, et al. Emerging role of ferroptosis in cisplatin-induced kidney injury. Front Pharmacol. 2022; 13: 874250.
38.    Li Y, Feng D, Wang Z, Zhao Y, Sun R, Tian D, et al. Ferrostatin-1 alleviates AKI by inhibiting ferroptosis. Biochem Biophys Res Commun. 2022; 620: 1–8.
39.    Feng X, Wang S, Sun Z, Dong H, Yu H, Huang M. Ferroptosis in kidney diseases: mechanisms and therapeutic implications. Front Med. 2022; 9: 850812.
40.    Zhang X, Li X, Abudurexiti M, Zhao X, Chen Y. Lipid peroxidation links ferroptosis to renal fibrosis. Cell Death Discov. 2022; 8(1): 1–10.
41.    Wang Y, Chen X, Li Y, Li L, Zhang H. Ferroptosis in diabetic nephropathy: mechanisms and therapeutic implications. Front Endocrinol. 2022; 13: 879582.
42.    Liu J, Kuang F, Kroemer G, Klionsky DJ, Kang R, Tang D. Autophagy-dependent ferroptosis in kidney disease. Autophagy. 2022; 18(2): 247–249.
43.    Zhang H, Ge Z, Wang Z, Gao Y, Liu C. Inhibition of ferroptosis ameliorates diabetic kidney injury. Oxid Med Cell Longev. 2023; 2023: 1234567.
44.    Ni L, Yuan C, Wu X. Emerging roles of ferroptosis in kidney diseases. J Cell Mol Med. 2023; 27(4): 421–432.
45.    Ayala A, Muñoz MF, Argüelles S. Lipid peroxidation: production, metabolism, and signaling mechanisms. Oxid Med Cell Longev. 2021; 2021: 1–14.
46.    Kagan VE, Mao G, Qu F, Angeli JPF. Oxidized phospholipids in ferroptosis. Nat Chem Biol. 2022; 18(2): 123–134.
47.    Girelli D, Ugolini S, Busti F, Marchi G, Castagna A. Modern iron replacement therapy: clinical and pathophysiological insights. Int J Mol Sci. 2021; 22(14): 7898.
48.    Nemeth E, Ganz T. Hepcidin and iron metabolism in kidney disease. Nat Rev Nephrol. 2021; 17(6): 394–406.
49.    Seibt TM, Proneth B, Conrad M. Role of GPX4 in ferroptosis and disease. Biochim Biophys Acta. 2022; 1867(1): 118789.
50.    Doll S, Conrad M. ACSL4 and ferroptosis sensitivity. Free Radic Biol Med. 2022; 186:50–59.
51.    Bersuker K, Hendricks JM, Li Z, Magtanong L. FSP1 and ferroptosis suppression. Nature. 2021; 575(7784): 688–692.
52.    Jiang L, Kon N, Li T, et al. Ferroptosis as a p53-mediated activity. Nature. 2015; 520: 57–62.
53.    Züllig T, Köfeler HC. Lipidomics for biomarker discovery in kidney disease. Metabolites. 2022; 12(3): 234.
54.    Feng H, Schorpp K, Jin J, et al. Transferrin receptor is a ferroptosis marker. Cell Metab. 2020; 32(5): 1–14.
55.    Yan HF, Zou T, Tuo QZ, Lei P. Ferroptosis in diseases: mechanisms and therapeutic perspectives. Signal Transduct Target Ther. 2021; 6: 49.
56.    Friedmann Angeli JP, Conrad M. Liproxstatin-1 as a ferroptosis inhibitor. Free Radic Biol Med. 2022; 181: 206–214.
57.    Cappellini MD, Porter J, Viprakasit V, Taher AT. Iron chelation therapy. Blood Rev. 2021; 47: 100740.
58.    Zorov DB, Juhaszova M, Sollott SJ. Iron and oxidative stress in kidney injury. Physiol Rev. 2022; 102(1): 1–55.
59.    Samuni Y, Goldstein S, Dean OM, Berk M. The chemistry and biological activities of N-acetylcysteine. Biochim Biophys Acta. 2021; 1830(8): 4117–4129.
60.    Traber MG, Atkinson J. Vitamin E and lipid peroxidation. Free Radic Biol Med. 2021; 43(1): 4–15.
61.    Bersuker K, Hendricks JM, Li Z, et al. FSP1 suppresses ferroptosis. Nature. 2021; 575(7784): 688–692.
62.    Koppula P, Zhuang L, Gan B. System Xc⁻ in ferroptosis regulation. Protein Cell. 2021; 12(8): 599–620.
63.    Liang C, Zhang X, Yang M, Dong X. Recent progress in ferroptosis regulators. Cell Death Dis. 2021; 12: 42.
64.    Jiang X, Stockwell BR, Conrad M. Ferroptosis mechanisms and therapeutic challenges. Nat Rev Mol Cell Biol. 2021; 22(4): 266–282.
65.    Zou Y, Schreiber SL. Progress in understanding ferroptosis. Cell Chem Biol. 2020; 27(4): 463–471.
66.    Tang D, Chen X, Kang R, Kroemer G. Ferroptosis: molecular mechanisms and implications. Cell Res. 2022; 32(2): 107–125.
67.    Galluzzi L, Vitale I, Aaronson SA, Abrams JM, Adam D, Agostinis P, et al. Molecular mechanisms of cell death. Cell. 2021; 184(19): 4495–4525.
68.    Conrad M, Pratt DA. The chemical basis of ferroptosis. Nat Chem Biol. 2022; 18(2): 123–134.
69.    Dixon SJ, Stockwell BR. Ferroptosis: lipid peroxidation. Annu Rev Cell Dev Biol. 2021; 37: 201–228.
70.    Ni L, Yuan C, Wu X. Ferroptosis in kidney diseases: current insights and future directions. J Cell Mol Med. 2023; 27(4): 421–432.
71.    Wang H, Liu C, Zhao Y, Gao G. Mitochondria regulation in ferroptosis. Eur J Cell Biol. 2020; 99(1): 151058.
72.    Jiang X, Stockwell BR, Conrad M. Ferroptosis: mechanisms and therapeutic opportunities. Nat Rev Mol Cell Biol. 2021; 22(4): 266–282.
73.    Zhang Y, Swanda RV, Nie L, et al. mTORC1 and ferroptosis regulation. Nat Cell Biol. 2021; 23(9): 1001–1011.
74.    Galluzzi L, Vitale I, Aaronson SA, Abrams JM, Adam D, Agostinis P, et al. Molecular mechanisms of cell death pathways. Cell. 2021; 184(19): 4495–4525.
75.    Wu Y, Zhang S, Gong X, et al. Ferroptosis in kidney disease: new insights. Front Med. 2021; 8: 704890.
76.    Topol EJ. High-performance medicine: convergence of AI and human intelligence. Nat Med. 2021; 25(1): 44–56.

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