Pathogenesis, Biomarkers, and Therapeutic Prospects of Sepsis-Associated Acute Kidney Injury

¹ College of Clinical Medicine, North China University of Science and Technology, Tangshan 063000, Hebei, China; Department of Critical Care Medicine I, Tangshan Worker’s Hospital Affiliated to North China University of Science and Technology, Tangshan 063000, Hebei, China,

² Department of Critical Care Medicine I, Hebei Medical University, Tangshan Workers’ Hospital Affiliated to Hebei Medical University, Tangshan 063000, Hebei, China,

³ Department of Critical Care Medicine I, Tangshan Worker’s Hospital Affiliated to North China University of Science and Technology, Tangshan 063000, Hebei, China,

UR 2025 , 3(4), 22–33; https://doi.org/10.26689/ur.v3i4.13540

© 2025 by the Authors. Licensee Whioce Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

Abstract

Sepsis-associated acute kidney injury (SA-AKI) is a common critical complication in the ICU, characterized by a complex pathogenesis involving the interplay of multiple factors such as inflammatory imbalance, vascular dysfunction, coagulation disorders, and cellular metabolic abnormalities. Traditional diagnostic indicators like serum creatinine and blood urea nitrogen exhibit lag time, making early identification challenging. In recent years, novel biomarkers have provided new directions for early diagnosis and risk stratification, including tubular injury markers (KIM-1, NGAL, L-FABP), renal function and glomerular injury markers (CysC, sCD35-uEV), cell cycle arrest markers ([TIMP-2] × [IGFBP7]), and inflammatory markers (IL-18, sTREM-1). Currently, supportive therapy remains the mainstay of treatment, encompassing early anti-infection measures, hemodynamic optimization, and timely renal replacement therapy. Novel therapeutic targets addressing the pathogenesis, such as regulating pyroptosis and improving mitochondrial dysfunction, are currently in preclinical and early clinical research stages, offering hope for future specific treatments.

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