Mineralocorticoid Receptor Antagonism: A Promising Therapeutic Approach to Treat Ischemic AKI

Acute kidney injury (AKI) is a common complication in hospitalized patients. One of the leading causes of AKI is renal ischemia/reperfusion (IR). In spite of all the progress made in acquiring knowledge about the mechanisms involved in AKI, no pharmacologic approach has yet become successful in clinical trials. Recent evidence suggests that mineralocorticoid receptor (MR) antagonism may be a useful strategy to prevent or treat AKI induced by IR. Here, we summarize the experimental work that supports MR antagonism as a potential approach to treat this disease. We also review the evidence that identifies a critical mechanism participating in the sustained vasoconstriction during kidney IR and uncovers that this mechanism is targeted by MR antagonists, thus explaining their beneficial effects.