Circular RNAs in Acute Kidney Injury: Roles in Pathophysiology and Implications for Clinical Management

Acute kidney injury (AKI) is a common clinical condition, results in patient morbidity and mortality, and incurs considerable health care costs. Sepsis, ischaemia-reperfusion injury (IRI) and drug nephrotoxicity are the leading causes. Mounting evidence suggests that perturbations in circular RNAs (circRNAs) are observed in AKI of various aetiologies, and have pathogenic significance. Aberrant circRNA expressions can cause altered intracellular signalling, exaggerated oxidative stress, increased cellular apoptosis, excess inflammation, and tissue injury in AKI due to sepsis or IRI. While circRNAs are dysregulated in drug-induced AKI, their roles in pathogenesis are less well-characterised. CircRNAs also show potential for clinical application in diagnosis, prognostication, monitoring, and treatment. Prospective observational studies are needed to investigate the role of circRNAs in the clinical management of AKI, with special focus on the safety of therapeutic interventions targeting circRNAs and the avoidance of untoward off-target effects.

Automated summary

Acute kidney injury (AKI) is a common clinical condition with various causes. Perturbations in circular RNAs (circRNAs) have been observed in AKI and are believed to have pathogenic significance, leading to altered intracellular signaling, oxidative stress, apoptosis, inflammation, and tissue injury. CircRNAs show potential for clinical application in the diagnosis, prognosis, monitoring, and treatment of AKI. Prospective observational studies are needed to further investigate the role of circRNAs in the clinical management of AKI.