As we move into 2025, the field of acute kidney injury (AKI) research continues to evolve, promising exciting advances in science, technology, and patient care. Based on recent developments and presentations, the following are key trends to watch:
1. Interorgan communication in AKI
Emerging research is shedding light on the critical interplay between organs during AKI. The Kidney Week 2024 presentation “Interorgan Cross-Talk: Kidney Injury and More” emphasized the systemic effects of AKI, moving beyond kidney-centric models to study crosstalk among the kidney, gut, heart, brain, lungs, and other organs (1). Understanding these connections could unlock new therapeutic approaches targeting systemic inflammation and organ protection.
2. Advancements in prognostication and management in AKI
Oral abstracts presented at Kidney Week last year highlighted key advancements in predicting and managing AKI. Researchers are improving risk stratification using biomarkers and uncovering new insights into AKI subtypes through precision medicine. Innovative tools, such as ultrasound-guided diuretic therapy and muscle ultrasonography, are being studied to predict fluid responsiveness and aid in patient management. These approaches aim to enhance care for patients who are critically ill by streamlining care transitions and improving recovery predictions. Together, these studies offer practical strategies to personalize and optimize AKI treatment.
3. Novel therapeutic pathways
Emerging therapies are paving the way for transformative AKI treatment through metabolic reprogramming and regenerative medicine. The LiMiT AKI trial, for example, is investigating metformin as a treatment for sepsis-associated AKI (2). By activating kidney tubular adenosine monophosphate-activated protein kinase, metformin has shown potential to reduce AKI severity and mortality in animal models (3). At the same time, regenerative medicine is advancing with mesenchymal stem cell (MSC) therapies. MSCs provide anti-inflammatory and tissue-regenerative benefits, and early trials confirm their safety (4). Future innovations, such as engineered extracellular vesicles derived from MSCs, hold promise for even greater therapeutic efficacy. These therapies reflect a multifaceted approach to addressing AKI's systemic and localized impacts.
This year promises to be a transformative year for AKI research, driven by breakthroughs in interorgan communication, prognostication tools, and therapeutic innovations. By combining systemic insights, advanced management strategies, and cutting-edge therapies, researchers and clinicians are redefining the future of AKI care.
Footnotes
References
- 1.↑
Li X, et al. Organ crosstalk in acute kidney injury: Evidence and mechanisms. J Clin Med 2022; 11:6637. doi: 10.3390/jcm11226637
- 2.↑
Saraiva IE, et al. Metformin for sepsis-associated AKI: A protocol for the randomized clinical trial of the Safety and Feasibility of Metformin as a Treatment for Sepsis-Associated AKI (LiMiT AKI). BMJ Open 2024; 14:e081120. doi: 10.1136/bmjopen-2023-081120
- 3.↑
Escobar DA, et al. Adenosine monophosphate-activated protein kinase activation protects against sepsis-induced organ injury and inflammation. J Surg Res 2015; 194:262–272. doi: 10.1016/j.jss.2014.10.009
- 4.↑
Hickson LJ, et al. Progress toward the clinical application of mesenchymal stromal cells and other disease-modulating regenerative therapies: Examples from the field of nephrology. Kidney360 2021; 2:542–557. doi: 10.34067/KID.0005692020
