Journal
PHARMACOLOGY & THERAPEUTICS
Volume 200, Issue -, Pages 1-12Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.pharmthera.2019.04.001
Keywords
Acute kidney injury; Ischemia; Reperfusion; Renal physiology
Categories
Funding
- Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES) - Brazil
- Carlos Chagas Filho Rio de Janeiro State Research Foundation (FAPERJ) - Brazil [E-26/171.137/2006, E-26/111.665/2008]
- Science Without Borders grant from CNPq-Brazil [420584/2013-7]
- National Institutes of Health (NIH) -USA [DK104375, U54 GM104940, UL1TR001417]
- Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) -Brazil
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Acute kidney injury (AKI) is defined as a decrease in kidney function within hours, which encompasses both injury and impairment of renal function. AKI is not considered a pathological condition of single organ failure, but a syndrome in which the kidney plays an active role in the progression of multi-organ dysfunction. The incidence rate of AKI is increasing and becoming a common (8-16% of hospital admissions) and serious disease (four-fold increased hospital mortality) affecting public health costs worldwide. AKI also affects the young and previously healthy individuals affected by infectious diseases in Latin America. Because of the multi factorial pathophysiological mechanisms, there is no effective pharmacological therapy that prevents the evolution or reverses the injury once established; therefore, renal replacement therapy is the only current alternative available for renal patients. The awareness of an accurate and prompt recognition of AKI underlying the various clinical phenotypes is an urgent need for more effective therapeutic interventions to diminish mortality and socio-economic impacts of AKI. The use of biomarkers as an indicator of the initial stage of the disease is critical and the cornerstone to fulfill the gaps in the field. This review discusses emerging strategies from basic science toward the anticipation of features, treatment of AKI, and new treatments using pharmacological and stem cell therapies. We will also highlight bioartificial kidney studies, addressing the limitations of the development of this innovative technology. (C) 2019 Elsevier Inc. All rights reserved.
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