Study objective: Sorafenib an antiangiogenic drug which are widely used in cancer treatment, and it inhibits vascular endothelial growth factor (VEGF) and tyrosine kinases (TK)involved in both tumor cell proliferation and angiogenesis. Unfortunately, VEGF and TK inhibitors cause severe kidney glomerular injury and proteinuria. Kidney injury that occurs with sorafenib chemotherapeutic treatment is a major clinical challenge that lacks a drug to revert or reduce this kidney glomerular cell damage. Hypothesis: Epoxyeicosatrienoic acid (EET) mimics reduce the nephrotoxic effects of sorafenib on glomerular mesangial cells. Methodology: Human renal mesangial cells (HRMCs) were cultured at 37˚C in RPMI 1640 medium containing 10% FBS, 100 U/ml penicillin, and 0.1 mg/ml streptomycin. Live cell imaging was performed to monitor real-time cell death activity in HRMCs. Apoptosis was determined using the caspase 3/7 dye and the HRMCs cells were imaged every 2 hours for 72 hours using the Incucyte system. HMRCs were tested under four conditions: 1) Sorafenib (10 μM), 2) Sorafenib (10 μM) plus 8,9-EET analogs (1 μM), 3) Sorafenib (10 μM) plus 8,9-EET analogs (3 μM), 4) Sorafenib (10 μM) plus 8,9-EET analogs (10 μM). Thirteen 8,9-EET analogs were also tested for soluble epoxide hydrolase (sEH) inhibitory activity against human sEH recombinant protein. Results: Sorafenib caused significant cell death and increased caspase 3/7 activity in HRMCs. Nine of the 8,9-EET analogs were ineffective in reducing sorafenib induced HRMC cell death and caspase 3/7 activity. Four 8,9-EET analogs in a dose-dependent manner reduced sorafenib induced cell death in HRMCs. This preliminary structure activity relationship analysis revealed an oxamide group as a bioisostere for the epoxide in the 8,9-position of the fatty acid chain, producing protective effects against sorafenib induced cell death in HRMCs. Gratifyingly, this group lacked significant sEH-inhibitory activity. The 8,9-EET analogs RM-84 and MBD-32 reduced sorafenib induced caspase 3/7 activity by 20-40% in HRMCs. Additional protective action was found with the 8,9-EET analogs MDB-52-I the MDB-52-II which dose dependently reduced sorafenib induced caspase 3/7 activity by 60-90% in HRMCs. Conclusion: Collectively, these findings demonstrate the potential for 8,9-EET analogs as a therapeutic strategy against sorafenib-induced glomerular nephrotoxicity. Arkansas Research Alliance This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.