急性肾损伤（AKI）已成为全球健康危机，其死亡率超过了几种癌症和心力衰竭的死亡率。缺乏有效的治疗方法，加上诊断方面的挑战和肾移植的高昂费用，凸显了探索 AKI 新的治疗靶点和策略的迫切需要。了解 AKI 复杂的病理生理学对于这项工作至关重要。 apelinergic 系统的组成部分，即 apelin 和 elabela/toddler，及其受体，在各种肾细胞中显着表达，并在肾脏研究中引起了极大的关注。最近的研究强调了 AKI 中肾上腺能系统的肾脏保护作用。该系统通过调节多种病理生理过程发挥其保护作用，包括减少内质网（ER）应激、改善线粒体动力学、抑制炎症和细胞凋亡、通过肾血管舒张促进利尿以及抵消活性氧（ROS）的影响。尽管取得了这些进展，但猿能系统在 AKI 进展中的确切参与仍不清楚。此外，apelin-13 在 AKI 中的治疗潜力尚未完全了解。本综述旨在阐明 apelinergic 系统在 AKI 中的作用及其与 AKI 进展中涉及的关键病理机制的相互作用。此外，我们还讨论了外源性 apelin-13 疗法的当前临床状况，提供了指导未来针对 AKI 的 apelin 研究的见解。版权所有 © 2024 Elsevier Inc. 保留所有权利。

Acute kidney injury (AKI) has emerged as a global health crisis, surpassing mortality rates associated with several cancers and heart failure. The lack of effective therapies, coupled with challenges in diagnosis and the high cost of kidney transplantation, underscores the urgent need to explore novel therapeutic targets and strategies for AKI. Understanding the intricate pathophysiology of AKI is paramount in this endeavor. The components of the apelinergic system-namely, apelin and elabela/toddler, along with their receptor-are prominently expressed in various kidney cells and have garnered significant attention in renal research. Recent studies have highlighted the renoprotective role of the apelinergic system in AKI. This system exerts its protective effects by modulating several pathophysiological processes, including reducing endoplasmic reticulum (ER) stress, improving mitochondrial dynamics, inhibiting inflammation and apoptosis, promoting diuresis through vasodilation of renal vasculature, and counteracting the effects of reactive oxygen species (ROS). Despite these advancements, the precise involvement of the apelinergic system in the progression of AKI remains unclear. Furthermore, the therapeutic potential of apelin-13 in AKI is not fully understood. This review aims to elucidate the role of the apelinergic system in AKI and its interactions with key pathomechanisms involved in the progression of AKI. Additionally, we discuss the current clinical status of exogenous apelin-13 therapy, providing insights that will guide future research on apelin against AKI.Copyright © 2024 Elsevier Inc. All rights reserved.