Advances and Challenges on New Therapies and Clinical Targets of Acute Kidney Injury

Acute kidney injury (AKI) is encountered in high-risk hospital settings where patients often suffer systemic illnesses, undergo surgery, or receive medications toxic to the kidneys. It is associated with high morbidity and mortality. Despite advances in understanding the pathophysiologic mechanisms involved in AKI, our ability to detect AKI early is limited, and outcomes remain unchanged. Once AKI is identified by the traditional markers of urine output and serum creatinine, the main therapeutic intervention is usually supportive care and/or renal replacement therapy until renal injury resolves. Urine biomarkers provide an optimistic future, offering the ability to identify patients at high risk for AKI such that preventative measures can be introduced. In this article, the etiologies of AKI are discussed, new biomarkers are assessed, and areas for further investigation are suggested.