Sina Salem Ahim
1 
, Ali Emadzadeh
2 , Shirin Shamsghahfarokhi
3 , Iman Zafar Asoodeh
4 , Farid Rahbari
5 , Hooman Esfahani
6 , Hamid Rastad
7 , Rasoul Jafari Arismani
8* 1 General Medicine, Fasa University of Medical Sciences, Fasa, Iran
2 Department of Internal Medicine, MMS.C, Islamic Azad University, Mashhad, Iran
3 Department of Internal Medicine, School of Medicine, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
4 Department of Anesthesiology and ICU, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
5 Department of Nursing, Nursing and Midwifery School, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
6 Department of Emergency Medicine, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
7 Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
8 Department of Urologic Surgery, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
Abstract
Recovery of renal function and structure following AKI is a complex and multifactorial process involving coordinated tubular epithelial regeneration, resolution of inflammation, restoration of microvascular integrity, and remodeling of the extracellular matrix. Clinical recovery is variable and influenced by injury severity, comorbidities, and therapeutic interventions. Advances in biomarkers and imaging techniques enhance early prediction and monitoring of recovery trajectories. Although no definitive therapies currently exist to reliably speed recovery, promising approaches, including stem cell secretome administration and growth factor modulation, are in development. Long-term consequences of incomplete structural repair highlight the importance of sustained patient follow-up after apparent recovery from AKI.
Implication for health policy/practice/research/medical education:
Acute kidney injury (AKI) is a highly prevalent clinical syndrome characterized by an abrupt decline in renal function that manifests over hours to days. It is associated with increased morbidity and mortality worldwide and represents a significant challenge in both hospital and critical care settings. Although many patients experience some degree of recovery after AKI, the extent and completeness of renal functional and structural restoration can vary widely, with profound implications for long-term outcomes, including progression to chronic kidney disease and end-stage renal disease. Identification of mechanisms, clinical course, and predictors of renal recovery after AKI is thus critical for optimizing patient management and developing therapies to enhance repair.
Please cite this paper as: Salem Ahim S, Emadzadeh A, Shamsghahfarokhi Sh, Zafar Asoodeh I, Rahbari F, Esfahani H, Rastad H, Jafari Arismani R. Recovery of renal function and structure following acute kidney injury. J Nephropathol. 2026;15(1):e27686. DOI: 10.34172/jnp.2025.27686.