Pleiotropic effects of statins on acute kidney injury: involvement of Kruppel-like factor 4

Statins, the inhibitors of 3-hydroxy-3-methylglutaryl-coenzyme A reductase, are potent cholesterol-lowering drugs used for primary and secondary prevention of coronary artery disease. They also possess multiple beneficial effects independent of their cholesterol-lowering properties, which are called as their pleiotropic effects. The results of recent studies have revealed that statins exert their pleiotropic effects in the kidneys, in that they are protective against acute kidney injury (AKI). Moreover, Kruppel-like factor 4, a zinc-finger transcription factor, in endothelial cells has been identified as a novel mediator of statins. This article summarizes the pleiotropic effects of statins on AKI, and reviews the recent progress in our understanding of the regulatory mechanisms involved in statin-mediated protection against AKI.