Emerging treatments
Novel therapeutic agents
Although several drugs have been tested in animal models of ATN, none of them have demonstrated efficacy in humans and there are no US Food and Drug Administration (FDA)-approved therapies for acute kidney injury (AKI). New therapeutic targets are being developed for future treatments.[53] Apoptosis inhibitors have been identified as a potential target, driven by the pathophysiology of the renal ischaemic processes. p53 is a protein that plays a fundamental role in cellular apoptosis. Its activation is an important pathogenic mechanism for kidney injury in renal ischaemia-reperfusion. Knockout of p53 from proximal tubules, but not other tubule segments, has been shown to protect against ischaemic AKI.[54] Studies are also investigating the use of repair agents, such as hepatocyte growth factor (HGF), which promotes cell proliferation, survival regeneration, and injury repair. Studies have shown that HGF improves renal haemodynamic recovery after ischaemia-reperfusion.[55] Other targets currently being evaluated include antioxidants (e.g., propofol) or haemodynamic modulators such as angiotensin II or levosimendan after cardiac surgery. Atrial natriuretic peptide, growth factors, pentoxifylline, and cilastatin are also emerging treatments that require further research.
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