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2018 ; 38
(1
): 88-97
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Translating Knowledge Into Therapy for Acute Kidney Injury
#MMPMID29291764
de Caestecker M
; Harris R
Semin Nephrol
2018[Jan]; 38
(1
): 88-97
PMID29291764
show ga
No therapies have been shown to improve outcomes in patients with acute kidney
injury (AKI). Given the high morbidity and mortality associated with AKI this
represents an important unmet medical need. A common feature of all of the
therapeutic development efforts for AKI is that none were driven by target
selection or preclinical modeling that was based primarily on human data. This is
important when considering a heterogeneous and dynamic condition such as AKI, in
which in the absence of more accurate molecular classifications, clinical cohorts
are likely to include patients with different types of injury at different stages
in the injury and repair continuum. The National Institutes of Health precision
medicine initiative offers an opportunity to address this. By creating a
molecular tissue atlas of AKI, defining patient subgroups, and identifying
critical cells and pathways involved in human AKI, this initiative has the
potential to transform our current approach to therapeutic discovery. In this
review, we discuss the opportunities and challenges that this initiative
presents, with a specific focus on AKI, what additional efforts will be needed to
apply these discoveries to therapeutic development, and how we believe this
effort might lead to the development of new therapeutics for subsets of patients
with AKI.