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Nephrol Dial Transplant. 2016 Jan;31(1):16-22. doi: 10.1093/ndt/gfv130. Epub 2015 Jun 4.

Cell-cycle arrest and acute kidney injury: the light and the dark sides.

Author information

1
Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
2
Department of Medicine, Division of Intensive Care Medicine and Division of Nephrology, Veterans Affairs Medical Center, Washington, DC, USA.

Abstract

Acute kidney injury (AKI) is a common consequence of systemic illness or injury and it complicates several forms of major surgery. Two major difficulties have hampered progress in AKI research and clinical management. AKI is difficult to detect early and its pathogenesis is still poorly understood. We recently reported results from multi-center studies where two urinary markers of cell-cycle arrest, tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) were validated for development of AKI well ahead of clinical manifestations--azotemia and oliguria. Cell-cycle arrest is known to be involved in the pathogenesis of AKI and this 'dark side' may also involve progression to chronic kidney disease. However, cell-cycle arrest has a 'light side' as well, since this mechanism can protect cells from the disastrous consequences of entering cell division with damaged DNA or insufficient bioenergetic resources during injury or stress. Whether we can use the light side to help prevent AKI remains to be seen, but there is already evidence that cell-cycle arrest biomarkers are indicators of both sides of this complex physiology.

KEYWORDS:

acute kidney injury; cell-cycle arrest; insulin-like growth factor-binding protein 7; tissue inhibitor of metalloproteinases-2

PMID:
26044835
PMCID:
PMC4703048
DOI:
10.1093/ndt/gfv130
[Indexed for MEDLINE]
Free PMC Article

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