MicroRNAs in acute kidney injury

Acute kidney injury (AKI) is a clinical syndrome with high morbidity and mortality. AKI has emerged as a significant global public health issue, particularly among hospitalized patients, with the highest incidence observed in those admitted to intensive care units (ICUs). However, early diagnosis of AKI remains challenging due to the limited sensitivity and specificity of conventional biomarkers, including serum creatinine and urine output. Recently, microRNAs (miRNAs) have garnered increasing interest for their potential in the early detection and management of AKI. Owing to their high stability, ease of quantification, well-characterized regulatory functions, and close association with key pathophysiological processes, miRNAs are considered promising diagnostic and therapeutic candidates. Nevertheless, the clinical utility of miRNAs remains limited by confounding factors such as co-infections, comorbidities, and medication use, which may lead to false-positive results. Challenges also persist regarding off-target effects and developing safe and efficient delivery systems. Furthermore, only a few studies have systematically characterized miRNA expression profiles in AKI, considering its heterogeneous etiologies and the dynamic nature of miRNA regulation. Interactions between miRNAs and between miRNAs and non-coding RNAs such as circular (circRNAs) and long non-coding RNAs (lncRNAs) warrant further investigation.