Table 1 Human Trials of therapies for either treatment or prevention of AKI
Author, year | Therapeutic Agent | Proposed Mechanism of therapeutic agent | AKI patients | Therapeutic Agent administration as treatment of prevention of AKI | Outcome |
|---|---|---|---|---|---|
McCullough [11], 2016 | Alpha Melanocyte Stimulating Hormone | Anti-inflammatory cytokine | Ischaemia/Reperfusion due to cardiac surgery | Prevention | ↔ incidence of AKI ↔ NGAL ↔ Urine IL 18 ↔ Urine KIM-1 |
Swaminathan [12], 2018 | Mesenchymal Stem Cells | Paracrine and endocrine effects | Ischaemia/Reperfusion due to cardiac surgery | Treatment | ↔ time to recovery of kidney function ↔ dialysis requirement ↔ mortality |
Bagshaw [13], 2017 | Low Dose Furosemide | Reduces renal oxygen demand therefore alleviating oxidative stress | ICU admission with AKI | Treatment | ↔ worsening of AKI ↔ kidney recovery ↔ RRT use ↔ mortality |
Pickkers [14], 2018 | Alkaline Phosphatase | Attenuation of inflammatory response | Sepsis | Treatment | ↔ endogenous creatinine clearance ↑ RRT requirement ↔ kidney injury biomarkers |
Kitzler et al. [15], 2012 | Vitamin E and N-acetylcysteine | Vitamin E – antioxidative NAC – free radical scavenger | CKD stages 1–4 patients undergoing elective CT hence at risk of contrast induced AKI | Prevention | No patients developed contrast induced AKI ↔ change in creatinine clearance ↔ eGFR |
Amendola [16], 2018 | Goal- directed therapy | Maximises oxygen delivery and cardiac output to prevent tissue hypoxia. Correction of volume deficits and optimisation of haemodynamic status | Patients with early AKI in critical care | Treatment | ↔ serum creatinine levels ↔ RRT requirement ↔ AKI beyond 72 h ↔ length of hospital stay |
Ghaemian [17], 2018 | Remote Ischaemic Preconditioning | Release of mediators which attenuate kidney damage following brief induction of ischaemia followed by reperfusion. | Patients with CKD undergoing coronary angiography or angioplasty therefore at risk of contrast induced AKI | Prevention | ↔ serum cystatin C ↔ incidence of contrast induced AKI ↔ serum creatinine |
Amini [18], 2018 | Selenium, Vitamin C and N-Acetylcysteine | Antioxidants therefore prevent anti-oxidative stress | Patients undergoing off-pump coronary artery bypass graft surgery | Prevention | ↔ incidence of AKI ↔ time of AKI occurrence ↔ severity of AKI ↔ duration of AKI ↔ length of hospital stay ↔ in hospital mortality |