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Updated: Jan 15, 2026

Modeling Hypoxia/Reoxygenation Injury in Proximal Tubular Epithelial Cells
Published on: November 21, 2025
Toward Combinatorial Strategies to Improve Proximal Tubule Recovery Following Acute Kidney Injury
David A Bastos1, Lisa O Oti2, Carla L Ellis3
1Department of Medicine, Division of Nephrology & Hypertension, Feinberg Cardiovascular & Renal Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611; Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611.
Abstract:
Maintaining kidney health throughout the human lifespan remains a significant global challenge. Worldwide, an estimated 850 million people have some level of kidney disease, with many unaware because of asymptomatic progression. Whether initiated by acute or chronic insults, renal injury and disease can have life-threatening consequences requiring interventions spanning the gamut of supportive care to kidney replacement therapies. Design of precision therapeutics is likely to benefit from understanding the heterogenous cell types and states that arise in the context of kidney injury and disease. Here we review an array of cellular states that have been detected following acute ischemic kidney injury, hypothesized to promote transition to chronic kidney disease. We focused on studies describing the cellular states of the proximal tubule (PT), a segment of the nephron most vulnerable to ischemic injury. PT cells have been shown in preclinical animal studies to have a heterogeneous response to ischemic injury, including repaired and failed-repair cellular states, inter alia. We end by discussing targeting these cellular states and/or pathological processes.
Insights
Kidney disease affects millions globally. Understanding diverse cellular responses to acute kidney injury, particularly in proximal tubule cells, is crucial for developing targeted therapies to prevent chronic kidney disease progression.
Area of Science:
- Nephrology
- Cellular Biology
- Pathophysiology
Background:
- Kidney disease is a major global health issue affecting 850 million people.
- Many kidney diseases progress asymptomatically, delaying diagnosis and treatment.
- Renal injury can lead to severe health consequences, necessitating advanced medical interventions.
Purpose of the Study:
- To review cellular states arising after acute ischemic kidney injury.
- To identify cellular states that may contribute to the progression to chronic kidney disease.
- To focus on the heterogeneous responses of proximal tubule cells to ischemic injury.
Main Methods:
- Review of preclinical animal studies on ischemic kidney injury.
- Analysis of cellular states in the proximal tubule segment.
- Identification of repaired and failed-repair cellular states.
Main Results:
- Acute ischemic kidney injury induces diverse cellular states in the proximal tubule.
- Heterogeneous cellular responses, including failed repair, are observed.
- These cellular states are hypothesized to promote the transition to chronic kidney disease.
Conclusions:
- Understanding heterogeneous cellular states post-injury is key for precision therapeutics.
- Targeting specific cellular states or pathological processes may prevent chronic kidney disease.
- Further research into proximal tubule cell responses can inform therapeutic strategies.
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