Advances in therapeutic strategies for acute kidney injury

Acute Kidney Injury (AKI) is a complex clinical syndrome marked by a rapid decline in renal function, most commonly triggered by ischemia, hypoxia, or nephrotoxic insults, and is associated with significant morbidity and mortality. Despite advances in understanding its underlying mechanisms, current treatments remain predominantly supportive, with no effective therapies available to reverse or repair renal damage. Although biomarker-guided precision medicine holds promise, its clinical utility requires further validation through large-scale trials. This review summarizes recent progress in AKI therapy, with a particular focus on injury induced by nephrotoxic drugs (cisplatin, aminoglycosides, contrast media), sepsis, and ischemia-reperfusion. It discusses innovative strategies including nanomedicine-based drug delivery, plant-derived therapeutics, ferroptosis inhibition, and gene or microRNA-targeted approaches, alongside emerging clinical interventions and assessment tools. By bridging experimental findings with clinical application, this review provides insight into evolving therapeutic avenues and emphasizes the ongoing need for targeted, effective interventions to improve outcomes in AKI.