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Caffeine and neonatal acute kidney injury

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Abstract

Acute kidney injury is one of the most threatening diseases in neonates, with complex pathogenesis and limited treatment options. Caffeine is a commonly used central nervous system stimulant for treating apnea in preterm infants. There is compelling evidence that caffeine may have potential benefits for preventing neonatal acute kidney injury, but comprehensive reports are lacking in this area. Hence, this review aims to provide a summary of clinical data on the potential benefits of caffeine in improving neonatal acute kidney injury. Additionally, it delves into the molecular mechanisms underlying caffeine’s effects on acute kidney injury, with a focus on various aspects such as oxidative stress, adenosine receptors, mitochondrial dysfunction, endoplasmic reticulum stress, inflammasome, autophagy, p53, and gut microbiota. The ultimate goal of this review is to provide information for healthcare professionals regarding the link between caffeine and neonatal acute kidney injury and to identify gaps in our current understanding.

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Abbreviations

AKI:

Acute kidney injury

nAKI:

Neonatal AKI

ARs:

Adenosine receptors

CKD:

Chronic kidney disease

OS:

Oxidative stress

ERS:

Endoplasmic reticulum stress

AKT:

Protein kinase B

HSP:

Heat shock protein

ROS:

Reactive oxygen species

LPO:

Lipid peroxidation

DAMPs:

Damage-associated molecular patterns

TLRs:

Toll-like receptors

Nrf2:

Nuclear factor erythroid 2 related factor 2

HO-1:

Heme oxygenase-1

NQO-1:

NAD (P) H quinone oxidation reductase-1

GCLM:

Glutamate-cysteine ligase modifier subunit

SOD:

Superoxide dismutase

MAPK:

Mitogen-activated protein kinase

DRP1:

Dynamin-related protein 1

PGC-1α:

Peroxisome proliferator-activated receptor coactivator 1 alpha

ETC:

Electron transport chain

cAMP:

Cyclic adenosine monophosphate

PKA:

Protein kinase A

AMPK:

AMP-activated protein kinase

CaMK:

Calcium/calmodulin-dependent protein kinase

CREB:

CAMP receptor element binding protein

UPR:

Unfolded protein response

PERK:

Protein kinase RNA-like endoplasmic reticulum kinase

IRE1:

Inositol-requiring enzyme 1

ATF6:

Activating transcription factor 6

IL:

Interleukin

HMGB1:

High-mobility group box 1

BiP:

Binding immunoglobulin protein

NAFLD:

Non-alcoholic fatty liver disease

NLRP3:

Nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3

NF-κB:

Nuclear factor-kappa B

PTEN:

Phosphatase and tensin homolog

PI3K:

Phosphatidylinositol 3-kinase

SCFAs:

Short-chain fatty acids

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Acknowledgements

The authors would like to express their gratitude to EditSprings (https://www.editsprings.com/) for the expert linguistic services provided.

Funding

This article was supported by the National Natural Science Foundation of China (81571480), Sichuan Science and Technology Department Major Science and Technology Special Project (22ZDYF1470), and Luzhou Municipal People’s Government-Southwest Medical University Science and Technology Strategic Cooperation Project (2020LZXNYDJ03).

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China

    Kun Yang, Jinjing Liu, Ting He & Wenbin Dong

  2. Department of Perinatology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China

    Kun Yang, Jinjing Liu, Ting He & Wenbin Dong

  3. Sichuan Clinical Research Center for Birth Defects, Luzhou, 646000, China

    Kun Yang, Jinjing Liu, Ting He & Wenbin Dong

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  1. Kun Yang
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  4. Wenbin Dong
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KY and WD designed the manuscript. KY wrote the manuscript. KY, JL, and TH collected the data for the manuscript. KY, JL, TH, and WD revised the manuscript. All authors contributed to the manuscript and approved the submitted version.

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Correspondence to Wenbin Dong.

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Yang, K., Liu, J., He, T. et al. Caffeine and neonatal acute kidney injury. Pediatr Nephrol 39, 1355–1367 (2024). https://doi.org/10.1007/s00467-023-06122-6

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