Acute kidney injury is a common complication in critically ill patients with sepsis and/or septic shock. Further, some essential antimicrobial treatment drugs are themselves nephrotoxic. For this reason, timely diagnosis and adequate therapeutic management are paramount. Of potential acute kidney injury (AKI) biomarkers, non-protein-coding RNAs are a subject of ongoing research. This review covers the pathophysiology of vancomycin and gentamicin nephrotoxicity in particular, septic AKI and the microRNAs involved in the pathophysiology of both syndromes. PubMED, UptoDate, MEDLINE and Cochrane databases were searched, using the terms: biomarkers, acute kidney injury, antibiotic nephrotoxicity, sepsis, miRNA and nephrotoxicity. A comprehensive review describing pathophysiology and potential biomarkers of septic and toxic acute kidney injury in septic patients was conducted. In addition, five miRNAs: miR-15a-5p, miR-192-5p, miR-155-5p, miR-486-5p and miR-423-5p specific to septic and toxic acute kidney injury in septic patients, treated by nephrotoxic antibiotic agents (vancomycin and gentamicin) were identified. However, while these are at the stage of clinical testing, preclinical and clinical trials are needed before they can be considered useful biomarkers or therapeutic targets of AKI in the context of antibiotic nephrotoxicity or septic injury.

Department of Anesthesiology and Resuscitation University Hospital Ostrava 70852 Ostrava Czech Republic

Department of Biomedical Sciences Faculty of Medicine University of Ostrava 70300 Ostrava Czech Republic

Department of Clinical Studies Faculty of Medicine University of Ostrava 70300 Ostrava Czech Republic

Department of Internal Medicine 3 Nephrology Rheumatology and Endocrinology University Hospital and Faculty of Medicine and Dentistry Palacky University Olomouc 77900 Olomouc Czech Republic

Department of Internal Medicine University Hospital Ostrava 70852 Ostrava Czech Republic

Department of Laboratory Diagnostics Institute of Clinical Biochemistry and Clinical Pharmacology University Hospital Ostrava 70852 Ostrava Czech Republic

Institute of Clinical Pharmacology Faculty of Medicine University of Ostrava 70300 Ostrava Czech Republic

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