Odum James D, Hasson Denise C, Stanski Natalja L, Gómez Hernando, Soranno Danielle E
Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL.
Department of Pediatrics, Division of Pediatric Critical Care Medicine, Hassenfeld Children's Hospital, NYU Langone, New York, NY.
Semin Nephrol. 2025 Sep 10:151665. doi: 10.1016/j.semnephrol.2025.151665.
The global health impact of sepsis is difficult to understate. As a complication of sepsis, the development of sepsis-associated acute kidney injury (SA-AKI) significantly increases the risk of mortality. Although several epidemiological risk factors for SA-AKI are known, the heterogeneity of this syndrome-across patients, pathogens, and treatment responses-has hindered therapeutic innovation and contributed to persistently poor outcomes. Precision medicine offers a promising framework to address this complexity, yet a substantial translational gap remains between mechanistic insights from preclinical models and the therapeutic strategies used in clinical practice. To bridge this gap, researchers should consider aligning preclinical models with human sepsis and embrace SA-AKI heterogeneity to identify treatable, mechanistically informed subtypes (endotypes). These efforts could enable the development of personalized therapies aimed at reducing the burden of SA-AKI. Semin Nephrol 36:x-xx © 20XX Elsevier Inc. All rights reserved.
脓毒症对全球健康的影响难以低估。作为脓毒症的一种并发症，脓毒症相关急性肾损伤（SA-AKI）的发生显著增加了死亡风险。尽管已知一些SA-AKI的流行病学风险因素，但该综合征在患者、病原体和治疗反应方面的异质性阻碍了治疗创新，并导致预后持续不佳。精准医学提供了一个有前景的框架来应对这种复杂性，然而，临床前模型的机制性见解与临床实践中使用的治疗策略之间仍存在很大的转化差距。为了弥合这一差距，研究人员应考虑使临床前模型与人类脓毒症相匹配，并接受SA-AKI的异质性，以识别可治疗的、基于机制的亚型（内型）。这些努力可以推动旨在减轻SA-AKI负担的个性化疗法的发展。《肾脏病学研讨会》36:x-xx © 20XX爱思唯尔公司。保留所有权利。
