Despite decennia of research and numerous successful interventions in the preclinical setting, renal ischemia reperfusion (IR) injury remains a major problem in clinical practice, pointing toward a translational gap. Recently, two clinical studies on renal IR injury (manifested either as acute kidney injury or as delayed graft function) identified metabolic derailment as a key driver of renal IR injury. It was reasoned that these unambiguous metabolic findings enable direct alignment of clinical with preclinical data, thereby providing the opportunity to elaborate potential translational hurdles between preclinical research and the clinical context. A systematic review of studies that reported metabolic data in the context of renal IR was performed according to the PRISMA guidelines. The search (December 2020) identified 35 heterogeneous preclinical studies. The applied methodologies were compared, and metabolic outcomes were semi-quantified and aligned with the clinical data. This review identifies profound methodological challenges, such as the definition of IR injury, the follow-up time, and sampling techniques, as well as shortcomings in the reported metabolic information. In light of these findings, recommendations are provided in order to improve the translatability of preclinical models of renal IR injury.

中文翻译：

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临床前模型与临床肾缺血再灌注损伤：基于代谢特征的系统评价

尽管进行了数十年的研究并在临床前环境中进行了许多成功的干预，但肾缺血再灌注 (IR) 损伤仍然是临床实践中的一个主要问题，表明存在转化差距。最近，两项关于肾脏 IR 损伤（表现为急性肾损伤或延迟移植物功能）的临床研究确定代谢脱轨是肾脏 IR 损伤的关键驱动因素。据推测，这些明确的代谢发现使临床与临床前数据能够直接对齐，从而提供了详细说明临床前研究与临床背景之间潜在转化障碍的机会。根据 PRISMA 指南，对报告肾脏 IR 背景下代谢数据的研究进行了系统回顾。搜索（2020 年 12 月）确定了 35 项异质临床前研究。比较了所应用的方法，对代谢结果进行了半量化并与临床数据保持一致。这篇综述确定了深刻的方法学挑战，例如 IR 损伤的定义、随访时间和采样技术，以及报告的代谢信息中的缺点。鉴于这些发现，我们提供了一些建议，以提高肾脏 IR 损伤临床前模型的可翻译性。以及报告的代谢信息中的缺点。鉴于这些发现，我们提供了一些建议，以提高肾脏 IR 损伤临床前模型的可翻译性。以及报告的代谢信息中的缺点。鉴于这些发现，我们提供了一些建议，以提高肾脏 IR 损伤临床前模型的可翻译性。