Enlightening kidney pathophysiology

Abstract

Understanding the mechanics of acute kidney injury from toxins, ischemia and sepsis remains challenging. Molecular probes with high renal clearance have now been developed for real-time optical detection of early-stage biomarkers of drug-induced acute kidney injury, and for the understanding of the mechanisms of injury.

Fig. 1 |. Molecular renal probes for the detection of drug-induced acute kidney injury.

a,b, Real-time detection of AKI following nephrotoxin exposure using single-channel molecular renal probes that rely on near infra-red fluorescence (NIRF) signals (a), and dual-channel molecular renal probes that rely on near infra-red fluorescence and chemiluminescent signals (b). Adapted from ref. , Springer Nature Ltd.

Fig. 2 |. The approaches conventially used in drug development for acute kidney injury.

a, Single therapies have been developed for all patients with AKI or at risk of AKI. b, Clinically driven endophenotypic approaches may rely on parameters such as the underlying etiology or the stage of the disease. c, Mechanistically driven endophenotypic approaches may be useful in the future to distinguish differences in pathophysiologic mechanisms of acute kidney injury. Adapted from ref. , ASN.