MicroRNAs in Acute Kidney Injury
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Abstract
Acute kidney injury (AKI) is a common and significant problem. The pathophysiology of AKI involves hemodynamic change, cellular immune response, inflammation and obstruction of tubular cell. Following an episode of AKI, it results in the dedifferentiation, proliferation and redifferentiation of renal tubular epithelial cells. The diagnosis of AKI is traditionally based on levels in serum creatinine that in later years efforts in developing new biomarkers of AKI to detect injury prior to elevated levels in serum creatinine. The new biomarkers include NGAL and KIM-1. However, these biomarkers still lack precision in explaining the cause of AKI. Accordingly, cellular biology was initiated and then discovered an association between microRNAs and acute kidney injury at proximal tubule of mice. MicroRNAs are small non-coding RNA molecule, but it has an influence in controlling protein synthesis in translation process of cell and has led to the different gene expression. The majority of miRNAs are found in the cytoplasm of cell but they can also be found outside the cell, for example, blood and other body fluids (urine and breast milk). As microRNAs outside the cell are in a remarkably stable form and have distinct expression profile among different fluids, the microRNAs in blood and urine become a potential biomarker for the diagnosis of AKI. This promising tool can be used to predict AKI before serum creatinine rising. In the future, new interventions should be developed for inhibiting or activating microRNAs in the cell so that they can reduce severity of AKI and reduce risk for developing progressive chronic kidney disease.
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