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Acute Kidney Injury: From Molecular Pathology to Therapies

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: closed (20 July 2025) | Viewed by 356

Special Issue Editor


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Guest Editor
Department of Nephrology and Renal Transplantation, Unidade Local de Saude Santa Maria, Lisboa, Portugal
Interests: acute kidney injury; sepsis; critical care; renal replacement therapy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Over the past decades, acute kidney injury has emerged as a global problem across various clinical settings, consistently linked to high mortality and morbidity. Identifying at-risk patients and making an early diagnosis remain significant challenges for this condition, for which a specific treatment is yet to be found.

Although new biomarkers have been proposed for excluding AKI and assessing high-risk conditions, a more profound knowledge on pathophysiology is needed for the better understanding of different phenotypes and endotypes of this entity. Understanding molecular pathways and their interactions might be the key for pharmacological interventions aimed at effectively preventing acute kidney injury or its progression to acute kidney disease and chronic kidney disease.

This Special Issue aims to highlight new areas of research focused on the pathogenesis of acute kidney injury, including innovative studies on animal models, providing insights into the underlying mechanisms, novel biomarkers for the early diagnosis of AKI, and new therapeutic targets and strategies for acute kidney injury prevention and treatment, paving the way for more effective interventions and improved patient outcomes.

Dr. José António Lopes
Guest Editor

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Keywords

  • acute kidney injury
  • acute kidney disease
  • biomarkers
  • phenotypes
  • pathogenesis
  • risk identification
  • prognostic impact
  • therapeutic approach

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Published Papers (1 paper)

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Research

21 pages, 7856 KiB  
Article
Cilastatin Attenuates Acute Kidney Injury and Reduces Mortality in a Rat Model of Sepsis
by María Ángeles González-Nicolás, Blanca Humanes, Raquel Herrero, Mario Arenillas, Beatriz López, Antonio Ferruelo, José Ángel Lorente and Alberto Lázaro
Int. J. Mol. Sci. 2025, 26(16), 7927; https://doi.org/10.3390/ijms26167927 (registering DOI) - 16 Aug 2025
Abstract
Sepsis is a life-threatening condition caused by an abnormal host response to infection, leading to organ dysfunction and potentially death. Acute kidney injury (AKI) is a critical complication of sepsis. Various pathways, especially signaling through Toll-like receptors (TLRs) and the nucleotide-binding oligomerization domain, [...] Read more.
Sepsis is a life-threatening condition caused by an abnormal host response to infection, leading to organ dysfunction and potentially death. Acute kidney injury (AKI) is a critical complication of sepsis. Various pathways, especially signaling through Toll-like receptors (TLRs) and the nucleotide-binding oligomerization domain, leucine-rich repeat and pyrin domain-containing protein 3 (NLRP3) inflammasome, contribute to inflammation and tissue damage. Cilastatin, a renal dehydropeptidase I inhibitor, has shown promise in protecting against AKI induced by nephrotoxic drugs. This study assessed cilastatin’s effectiveness in preventing AKI and inflammation caused by sepsis and its impact on survival. Sepsis was induced in male Sprague-Dawley rats using the cecal ligation puncture (CLP) model, with four groups: sham (control), CLP, sham+cilastatin, and CLP+cilastatin. Cilastatin (150 mg/kg) was administered immediately and 24 h after sepsis induction. Kidney injury was evaluated 48 h later by assessing serum creatinine, blood urea nitrogen, glomerular filtration rate, proteinuria, kidney injury molecule-1 levels, and renal morphology. Inflammatory and fibrotic biomarkers, particularly related to the TLR4 and NLRP3 pathways, were also measured. Cilastatin treatment prevented kidney dysfunction, reduced inflammatory markers, and improved survival by 33%. These results suggest that cilastatin could be a beneficial therapeutic strategy for sepsis-related AKI, improving outcomes and reducing mortality. Full article
(This article belongs to the Special Issue Acute Kidney Injury: From Molecular Pathology to Therapies)
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