Problem/Issue Being Addressed: This project targets acute kidney injury (AKI) in ICU patients, specifically in sepsis or cardiac surgery cases. AKI affects over 50% of ICU patients and is associated with high mortality and long-term morbidity. Currently, AKI is diagnosed by renal function deterioration using plasma creatinine or urine output. The exact cause of AKI is unclear, but renal medulla hypoxia is thought to play a key role.
Why is it Important for Society? AKI in the ICU is a significant issue, with serious consequences, including high mortality and potential progression to end-stage renal disease. Improving AKI prevention and management is critical to enhancing ICU care, reducing healthcare burdens, and saving lives.
Overall Objectives: The project aims to evaluate the effectiveness of two renoprotective agents—GLP-1 receptor agonists (GLP-1 RA) and SGLT2 inhibitors (SGLT2i)—in preventing and reducing AKI in the ICU. The key objectives are:
Assess GLP-1 receptor activation and SGLT2 inhibition effects on kidney perfusion, oxygenation, and injury markers in an ovine septic shock-induced AKI model.
Evaluate SGLT2i effects on kidney perfusion and oxygenation using imaging in healthy humans.
Examine SGLT2i impact on AKI markers in cardiac surgery patients.
Conclusions of this Action: WP1+2. GLP-1 and SGLT2i did not show renoprotective effects in an ovine sepsis-AKI model. Sepsis-induced AKI may be too severe for these treatments. 3. Long-term SGLT2i treatment in diabetic patients improved kidney perfusion and oxygenation. 4. Short-term SGLT2i before and after cardiac surgery reduced postoperative AKI risk. A large multicenter trial has been initiated.
