逃避修复的DNA损伤可能导致发生突变，从而推动肿瘤发展。细胞对DNA损伤的反应可能会引起细胞衰老和细胞死亡，这些现象与老化有关。在肾脏中，DNA损伤已被提出与急性及慢性肾损伤以及肾细胞癌有关。肾脏对损伤DNA的化疗药物易感性已得到确认，但肾小管毛发病与DNA损伤应答之间的联系最近被报道。此外，人类遗传缺陷的DNA修复已突显出对肾脏特别有毒的DNA交联、DNA断裂和阻断转录的损伤作为损伤。小鼠的遗传工具，以及肾器官体和单细胞RNA测序技术的进步，为特定的肾细胞类型如何应对DNA损伤提供了重要的见解。新的观点是，在肾脏中，DNA损伤通过触发损伤反应和细胞增殖来影响局部微环境，以补充受损细胞，同时引起系统性反应，旨在减少暴露于基因毒性胁迫。因此，DNA损伤的病理后果对于损伤肾脏药物的肾毒性和人类DNA修复缺陷疾病中观察到的肾脏表型具有关键作用。© 2023. Springer Nature Limited.

DNA lesions that evade repair can lead to mutations that drive the development of cancer, and cellular responses to DNA damage can trigger senescence and cell death, which are associated with ageing. In the kidney, DNA damage has been implicated in both acute and chronic kidney injury, and in renal cell carcinoma. The susceptibility of the kidney to chemotherapeutic agents that damage DNA is well established, but an unexpected link between kidney ciliopathies and the DNA damage response has also been reported. In addition, human genetic deficiencies in DNA repair have highlighted DNA crosslinks, DNA breaks and transcription-blocking damage as lesions that are particularly toxic to the kidney. Genetic tools in mice, as well as advances in kidney organoid and single-cell RNA sequencing technologies, have provided important insights into how specific kidney cell types respond to DNA damage. The emerging view is that in the kidney, DNA damage affects the local microenvironment by triggering a damage response and cell proliferation to replenish injured cells, as well as inducing systemic responses aimed at reducing exposure to genotoxic stress. The pathological consequences of DNA damage are therefore key to the nephrotoxicity of DNA-damaging agents and the kidney phenotypes observed in human DNA repair-deficiency disorders.© 2023. Springer Nature Limited.