Lipids and lipid metabolites in the diagnosis, risk prediction and treatment of chronic kidney disease and acute kidney injury

Background/Introduction Acute kidney injury (AKI) and chronic kidney disease (CKD) represent the principal nephrological conditions encountered globally. Despite the diverse etiologies and pathogeneses associated with these disorders, both are characterized by disruptions in lipid metabolism, largely due to the frequent involvement of inflammatory mechanisms in the onset and progression of acute and chronic renal dysfunction. This review will examine two key areas: the diagnostic and prognostic relevance of lipids and their metabolites, particularly fatty acids, in AKI and CKD; and the potential therapeutic application or external modulation of lipid components in the management of these diseases. Methods The following databases were utilized for reference identification: PubMed, Web of Science, Cochrane Library, and Scopus. The search period spanned from 2010 to 2025. The search terms employed in various combinations included 'CKD', 'AKI', 'CRP', 'inflammation', 'serum fatty acids', 'lipids', 'lipid profile'. Results 28 studies were selected for further analysis. Twelve studies focused on diagnostics and prog-nostics in CKD, while nine addressed treatment strategies for CKD. The number of studies per-formed in AKI related to AKI was 5 (diagnostics/prognostics) and 2 (therapy). Conclusion In chronic kidney disease (CKD), free fatty acids may help to predict three clinical outcomes: mortality, progression of CKD, and cardiovascular risk. However, therapy-related references remain inconsistent, antiproteinuric effects of omega-3 fatty acids have been reported sporadically. The current data on lipids in AKI diagnostics, prognostics, and therapy is still too limited to draw any definitive conclusions. Nevertheless, this presents numerous opportunities for future ob-servational and interventional studies.