Small molecules as a source for acute kidney injury therapy

Acute kidney injury (AKI) is a sudden loss of kidney function that causes a rise in serum creatinine and a decrease in urine output, which leads to high morbidity and mortality. However, effective therapeutic drugs have not yet been developed due to the poor understanding of the cellular and molecular mechanisms of AKI. Recent studies have revealed that AKI leads to renal disorders, including inflammation, cell apoptosis, oxidative stress, mitochondrial dysfunction and autophagy, and multiple signaling pathways are involved in these disorders during the pathogenesis of AKI, which suggests that drugs specifically targeting these signaling pathways may be effective in preventing and treating AKI. In addition, a great number of small molecules show a therapeutic effect on AKI by targeting these signaling pathways and may be promising therapeutic drugs in the treatment of AKI. Moreover, an in-depth analysis of failed clinical trials is carried out to find out an effective strategy for AKI therapy. Taken together, this review focuses on the cellular and molecular mechanisms of AKI and the small molecules that alleviate AKI, which will provide new insight into AKI therapy.