The Clinical View of Sepsis-Associated AKI: How Basic Science Can Help Solve This Problem.

The global health impact of sepsis is difficult to understate. As a complication of sepsis, the development of sepsis-associated acute kidney injury (SA-AKI) significantly increases the risk of mortality. Although several epidemiological risk factors for SA-AKI are known, the heterogeneity of this syndrome-across patients, pathogens, and treatment responses-has hindered therapeutic innovation and contributed to persistently poor outcomes. Precision medicine offers a promising framework to address this complexity, yet a substantial translational gap remains between mechanistic insights from preclinical models and the therapeutic strategies used in clinical practice. To bridge this gap, researchers should consider aligning preclinical models with human sepsis and embrace SA-AKI heterogeneity to identify treatable, mechanistically informed subtypes (endotypes). These efforts could enable the development of personalized therapies aimed at reducing the burden of SA-AKI.