Novel Approaches in the Investigation of Acute Kidney Injury

Acute kidney injury (AKI) remains a significant health care concern. Many reports describe high mortality rates that largely have remained unchanged for several decades (1,2). With such a poor prognostic outlook, scientists have sought to develop novel therapies that are based on information gleaned from clinical studies as well as in vitro and in vivo models of renal injury. These approaches have been geared toward understanding molecular, cellular, and physiologic responses of renal injury and have led to a focus on pathways that are related to metabolism, oxidant stress, hemodynamics, inflammation, and growth factors, to name a few, as potential targets of therapy (3). Will such scientific approaches lead to therapies that bear promise and ultimately affect outcome? Thus far, they have not. It has become clear that a reevaluation of approaches in the study of AKI is at hand, including the incorporation of novel therapeutic approaches, better and more clinically relevant model systems, and the application of better prognostic indicators as a means to establish treatment.