Xu Yali, Zou Ping, Cao Xiaojing
Department of Pharmacy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Department of Pharmacy, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Expert Opin Pharmacother. 2022 Apr;23(6):713-726. doi: 10.1080/14656566.2022.2050214. Epub 2022 Mar 14.
Acute kidney injury (AKI) is a clinically critical disease exhibiting an acute decline in renal function. The lack of an effective prevention and treatment method equates to a high morbidity and mortality rate. Consequently, over the past few decades, many therapeutic drugs with different mechanisms of action have been proposed and gradually applied to the clinic. The involved drug mechanisms evaluated have included hemodynamic modulation, anti-inflammatory, antioxidant, repair agents, metabolic derangement and mitochondrial function.
The authors of this review provide the reader with a reference point for the latest advances in pharmacotherapy in acute kidney injury. This is achieved by the evaluation of the latest data collected on potential therapeutic drugs with different mechanisms of action, as well as their preclinical and clinical impact on AKI.
Presently, the vast majority of drugs are still in clinical development, which is a huge challenge. Nevertheless, in addition to current chemical drugs and gene therapy strategies, the advent of mesenchymal stem cell treatments and other emerging pharmaceutical strategies could enable clinicians to better treat AKI. Due to the nonselective distribution and low bioavailability of some of the latest pharmaceutical strategies, there is hope that these treatment options may provide more efficacious avenues.
急性肾损伤(AKI)是一种临床危急疾病,表现为肾功能急剧下降。缺乏有效的预防和治疗方法导致其发病率和死亡率居高不下。因此,在过去几十年中,人们提出了许多作用机制不同的治疗药物,并逐渐应用于临床。所评估的药物机制包括血流动力学调节、抗炎、抗氧化、修复剂、代谢紊乱和线粒体功能。
本综述的作者为读者提供了急性肾损伤药物治疗最新进展的参考点。这是通过评估收集到的关于具有不同作用机制的潜在治疗药物的最新数据,以及它们对急性肾损伤的临床前和临床影响来实现的。
目前,绝大多数药物仍处于临床开发阶段,这是一个巨大的挑战。然而,除了目前的化学药物和基因治疗策略外,间充质干细胞治疗等新兴药物策略的出现可能使临床医生能够更好地治疗急性肾损伤。由于一些最新药物策略的分布不具有选择性且生物利用度低,希望这些治疗选择能提供更有效的途径。