Medical University of Bialystok, Bialystok, Poland.
Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
Adv Med Sci. 2020 Sep;65(2):361-370. doi: 10.1016/j.advms.2020.06.004. Epub 2020 Jun 25.
Acute kidney injury (AKI) is a very common condition with high morbidity and mortality, which can be seen in 5-7% of all hospitalized patients and in up to 57% of all intensive care unit admissions. Despite recent advances in clinical care, the prevalence of AKI has been shown to increase with virtually no change in mortality. AKI is a complex syndrome occurring in a variety of clinical settings. Early detection is crucial to prevent irreversible loss of renal function. The pathogenesis of AKI is highly multifactorial and complex, including vasoconstriction, reactive oxygen species formation, cell death, abnormal immune modulators and growth factors. Emerging evidence from both human and animal studies suggests that dysregulation of iron metabolism may play a potentially important role in AKI. Therefore, targeting the iron homeostasis may provide a new therapeutic intervention for AKI. New therapeutic strategies including iron chelation therapy, targeting iron metabolism related proteins and direct inhibitors of ferroptosis are imperative to improve the outcomes of patients. Taking into consideration the complexity of AKI, one intervention may not be enough for therapeutic success. Future preclinical studies in animal disease models followed by well-designed clinical trials should be conducted to extend findings from animal AKI models to humans.
急性肾损伤（AKI）是一种非常常见的疾病，发病率和死亡率都很高，在所有住院患者中可达到 5-7%，在所有重症监护病房患者中可达到 57%。尽管在临床护理方面取得了最近的进展，但 AKI 的发病率已经显示出增加的趋势，而死亡率几乎没有变化。AKI 是一种发生在多种临床环境中的复杂综合征。早期发现对于预防肾功能不可逆转的丧失至关重要。AKI 的发病机制非常复杂，包括血管收缩、活性氧形成、细胞死亡、异常免疫调节剂和生长因子。来自人类和动物研究的新证据表明，铁代谢失调可能在 AKI 中发挥重要作用。因此，靶向铁稳态可能为 AKI 提供新的治疗干预。新的治疗策略，包括铁螯合疗法、靶向铁代谢相关蛋白和铁死亡的直接抑制剂，对于改善患者的预后至关重要。考虑到 AKI 的复杂性，一种干预措施可能不足以实现治疗成功。未来应在动物疾病模型中进行临床前研究，随后进行精心设计的临床试验，将动物 AKI 模型的研究结果扩展到人类。
