The kidneys vital for filtering the body's waste are highly vulnerable to drug-induced nephrotoxicity a leading cause of acute kidney injury (AKI) in hospitalized patients with up to 60% of cases linked to medications such as antibiotics chemotherapy and analgesics. This book addresses the urgent need to balance pharmacological innovation with kidney protection. Recent advances have deepened understanding of nephrotoxicity revealing complex molecular genetic and biomarker-driven mechanisms while multi-drug regimens and aging populations add further complexity. Designed for clinicians researchers and trainees the text covers epidemiology pathophysiology high-risk drug classes diagnostic tools (including biomarkers like KIM-1 and cystatin C) and prevention strategies illustrated by case studies and the 6R's of Nephrotoxicity framework. Collaborative and interdisciplinary it emphasizes stewardship vigilant monitoring and patient education. The book also explores future directions such as genomic risk prediction AI-driven pharmacovigilance and equitable kidney care aiming to inspire a commitment to safe prescribing and renal stewardship.