New drugs for acute kidney injury

Acute kidney injury (AKI) is common in critically ill patients and is associated with serious short and longterm complications, including chronic dialysis dependence, and increased mortality [1].There is no approved pharmacological therapy to prevent, treat or enhance recovery from AKI.Current strategies focus predominantly on preventing further deterioration of renal function [2,3].Challenges in determining the exact timing, etiology, and phase of AKI may account for the limited progress in this field.The use of additional biomarkers to define AKI may provide granularity enabling earlier detection [4,5].Nevertheless, research addressing the pathophysiology of AKI has identified potential therapeutic targets, including pathways involved in hemodynamics and oxygen delivery, inflammation, cellular metabolism and oxidative stress, apoptosis, and cellular repair and fibrosis [6].In future, identification of different AKI sub-phenotypes, informed by emerging time-sensitive and AKI phase-specific biomarkers, may aid accelerated and successful drug development in this critical area of unmet need.Here, we describe selected compounds that impact known pathophysiological processes and have been studied in humans (Fig. 1).