The therapeutic horizon of acute kidney injury in critical care: exploring pathology, promises, pitfalls, and progress

重症监护中急性肾损伤的治疗前景:探索病理、前景、挑战和进展

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Abstract

PURPOSE OF REVIEW: Acute kidney injury (AKI) is among the most common organ failures encountered in critically ill patients, contributing to both short-term and long-term morbidity and mortality. No targeted therapy currently prevents or treats AKI. This review highlights recent advances in its prevention and treatment within critical care. RECENT FINDINGS: Increased attention to AKI heterogeneity and subphenotypes, coupled with biomarker-driven research, has deepened understanding of its pathophysiology. Several clinical trials have shown no benefit or were stopped early for futility, yet others report promising therapeutic effects or identify potential interventions. These findings need confirmation in larger prospective studies, and their clinical relevance remains to be established. Continued investigation is required to delineate AKI subphenotypes and develop targeted therapies. SUMMARY: Several trials already demonstrate encouraging results in specific AKI subphenotypes, supported by growing insight into its complex pathophysiology. Although candidate interventions are still under evaluation, recent progress offers hope for improved preventive and therapeutic strategies in critically ill patients.

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