title: Emerging therapeutic targets of sepsis-associated acute kidney injury.
abstract: Sepsis-associated acute kidney injury (SA-AKI) is linked to high morbidity and mortality. To date, singular approaches to target specific pathways known to contribute to the pathogenesis of SA-AKI have failed. Because of the complexity of the pathogenesis of SA-AKI, a reassessment necessitates integrative approaches to therapeutics of SA-AKI that include general supportive therapies such as the use of vasopressors, fluids, antimicrobials, and target-specific and time-dependent therapeutics. There has been recent progress in our understanding of the pathogenesis and treatment of SA-AKI including the temporal nature of proinflammatory and anti-inflammatory processes. In this review, we discuss the clinical and experimental basis of emerging therapeutic approaches that focus on targeting early proinflammatory and late anti-inflammatory processes, as well as therapeutics that may enhance cellular survival and recovery. Finally, we include ongoing clinical trials in sepsis.
authors: Division of Nephrology, Center for Immunity, Inflammation and Regenerative Medicine, University of Virginia Health System, Charlottesville, VA.
authors: Sundararaman
authors: S
authors: Swaminathan
authors: Division of Nephrology, Center for Immunity, Inflammation and Regenerative Medicine, University of Virginia Health System, Charlottesville, VA.
authors: Mitchell H
authors: MH
authors: Rosner
authors: Division of Nephrology, Center for Immunity, Inflammation and Regenerative Medicine, University of Virginia Health System, Charlottesville, VA. Electronic address: mdo7y@virginia.edu.
authors: Mark D
authors: MD
authors: Okusa
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000628:therapy*; D000469:Alkaline Phosphatase / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D064987:Cell- and Tissue-Based Therapy / Q000379:methods; D063388:Endocannabinoids / Q000627:therapeutic use; D005440:Fluid Therapy / Q000379:methods; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D015213:Neuroimmunomodulation; D047493:PPAR alpha / Q000819:agonists; D018805:Sepsis / Q000150:complications / Q000628:therapy; D012772:Shock, Septic / Q000150:complications / Q000628:therapy*; D018180:Thrombomodulin / Q000627:therapeutic use; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D063388:Endocannabinoids; D047493:PPAR alpha; D018180:Thrombomodulin; D014662:Vasoconstrictor Agents; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D000469:Alkaline Phosphatase
keywords: Inflammation; cytokines; septic shock; therapeutics