Advances in pharmacotherapy for acute kidney injury

ABSTRACT

Introduction

Acute kidney injury (AKI) is a clinically critical disease exhibiting an acute decline in renal function. The lack of an effective prevention and treatment method equates to a high morbidity and mortality rate. Consequently, over the past few decades, many therapeutic drugs with different mechanisms of action have been proposed and gradually applied to the clinic. The involved drug mechanisms evaluated have included hemodynamic modulation, anti-inflammatory, antioxidant, repair agents, metabolic derangement and mitochondrial function.

Areas Covered

The authors of this review provide the reader with a reference point for the latest advances in pharmacotherapy in acute kidney injury. This is achieved by the evaluation of the latest data collected on potential therapeutic drugs with different mechanisms of action, as well as their preclinical and clinical impact on AKI.

Expert opinion

Presently, the vast majority of drugs are still in clinical development, which is a huge challenge. Nevertheless, in addition to current chemical drugs and gene therapy strategies, the advent of mesenchymal stem cell treatments and other emerging pharmaceutical strategies could enable clinicians to better treat AKI. Due to the nonselective distribution and low bioavailability of some of the latest pharmaceutical strategies, there is hope that these treatment options may provide more efficacious avenues.

KEYWORDS:

• Acute kidney injury
• hemodynamic modulators
• anti-inflammation
• antioxidants
• repair agents
• metabolic derangement
• mitochondrial functions

Declaration of Interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Article Highlights

• AKI is associated with poor clinical outcomes such as high mortality rate, extended hospital stays, and long-term health consequences, so effective therapeutic is desirable.

• The potential therapeutic drugs for AKI are classified as hemodynamic modulators, anti-inflammation, antioxidants, repair agents, metabolic derangement and mitochondrial functions.

• Alterations in kidney blood flow is recognized to be a critical factor in the development of AKI, and drugs with various mechanisms are used to improve renal hemodynamics.

• Oxidative stress plays an important role in the development of AKI, and several inorganic substances are employed as the therapeutic drugs.

• Nanotechnology is gradually being used for the treatment of AKI and may be useful in the future development of novel therapeutic strategies.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript has not been funded.