The role of epigenetic modifi - cation and the possibility of epigenetic therapy in the transition of acute kidney injury to chronic kidney disease

Abstract

Acute kidney injury (AKI) is a clinically common and life-threatening disease. AKI has become a global problem for human health due to its high prevalence, increased risk of complications, high mortality and high medical costs. Initially, researchers believed that the kidneys had an eff ective ability to regenerate and recover, but studies over the past 20 years have shown that it’s rarely true when we speak about the damage caused by AKI. Even when serum creatinine levels return to baseline, structural damage to the kidneys persists for a long time, leading to the development of chronic kidney disease (CKD). The mechanism for the transition of AKI to CKD has not been fully established. Epigenetic changes, such as histone modifi cation, DNA methylation, and noncoding RNAs, can play an important role in this process as regulators of gene expression. Epigenetic modifi cations are induced by hypoxia, which promotes the gene expression associated with infl ammatory factors and collagen secretion. This review discusses in detail the role of epigenetic modifi cations in the progression of AKI to CKD, the diagnostic value of biomarkers of epigenetic modifi cations in the chronic outcome of AKI, and the potential role of infl uencing epigenetic modifi cations that inhibit the transition of AKI to CKD and improve disease prognosis.