New trends in pharmacological treatment of acute kidney injury

Abstract

Acute kidney injury, previously known as acute renal failure (AKI), is defined as an abrupt decrease in kidney function that occurs within hours or days. This new nomenclature opens a new door for possibility of treatment of developing renal injury before progression to unresolved renal failure. AKI arises due to diverse etiologic factors that rely mainly on three categories namely, pre-renal, intrinsic renal, and post-renal factors with different clinical pictures, and confers a spectrum of injury ranging from mild to severe and sometimes leads to end-stage renal disease. Complexity of pathogenesis and other factors generate barriers to developing effective treatments despite a large number of experimental and clinical studies. In this review, recent advances in the potential of the currently used drugs for renoprotection, novel pharmacological targets, and prospective therapeutics for AKI are discussed. The information in this review was extracted from electronic resources (PubMed, Google Scholar, Wiley, Science Direct, Springer), and English scientific books by using keywords including kidney, injury, recent therapy, and pharmacological targets. The articles were carefully checked for their relevance to the current manuscript. Recent targets of cellular repair or regenerative processes involved in AKI such as autophagy, ferroptosis inhibition, and p53 antagonism seem to be effective in disease control. This may help researchers and clinicians to understand how to target the interrelated molecular and cellular mechanisms underlying the pathogenesis of AKI.