Several agents share a curious relationship between nephrotoxicity and renal carcinogenesis. One example involves the response to lead exposure, which can lead to either acute or chronic lead nephropathy and under some circumstances can be associated with renal tumors.

The general relationship between nephrotoxicity and renal carcinogenesis should be explored.

The technology that is likely to yield new markers is complex. Equally complex is the identification of susceptible populations with the appropriate clinical assessment of exposure and effect. The use of biologic markers is essential in the examination of xenobiotic-induced diseases and other diseases of the human kidney, bladder, and prostate. Comprehending the sequences of events is an iterative process that involves a complex data set derived from scientific advances in molecular biology, epidemiology, pathology, biochemistry, and clinical medicine. Assembly of those data into an organized framework will be a major step toward individual risk assessment and should be a long-term objective.

To achieve the desired goal of identifying more-useful markers, cooperation between laboratory scientists, epidemiologists, and clinical researchers should be encouraged. Assays, particularly those involving enzymes or molecular probes, must be replicable in different laboratories.