Human recombinant alkaline phosphatase: a promising, yet-to-be-tested agent for the treatment sepsis-induced acute kidney injury

Sepsis is defined as an organ dysfunction syndrome caused by the over-activation of inflammatory response (1,2). Kidney is one of the most commonly involved organs in sepsis, and there is a large body of evidence showing that even mild increase in serum creatinine contributes to significantly increased risk of death (3,4). Thus, strenuous efforts have been made to improve renal function during sepsis, including the avoidance of renal toxic agents, treatment with sodium bicarbonate to correct metabolic acidosis (5), and restriction of chloride-rich fluid and starch (3,6,7). However, the risk of acute kidney injury (AKI) is still high in the intensive care unit and a substantial number of patients requires renal replacement therapy to avoid life-threatening metabolic derangements.