Nephrotoxins can impact kidney function in multiple ways. Some toxins directly damage renal cells, while others disrupt blood flow, leading to ischemia. They can also interfere with the kidneys' ability to filter blood by causing inflammation or fibrosis. This damage can be acute, leading to sudden loss of kidney function, or chronic, resulting in progressive decline over time. The extent of damage often depends on the dose and duration of exposure to the nephrotoxin.