Impaired fatty acid metabolism in AKI: experimental evidence – a narrative review

Background Acute kidney injury (AKI) is a common and serious complication of hospitalized patients worldwide. In most cases, the syndrome is characterized by dysfunction/structural damage of the tubular epithelial cells. The metabolic feature is a reduction in cellular adenosine triphosphate (ATP) synthesis as a result of decreased fatty acid oxidation. Stabilization of the fatty acid (FA) oxidation process may influence the course of AKI, whether caused by endogenous or exogenous factors. In this narrative review, we discuss experimental evidence on the modulation of fatty acid metabolism in AKI. Methods Narrative review article. The following databases were searched for references: PubMed, Web of Science, Cochrane Library, Scopus. The period lasted from 2010 until May 2026. Results Finally, 16 articles on the modulation of fatty acid metabolism in experimental AKI were identified. Disturbances in the FA oxidation process are associated with an aggravation of renal dysfunction in AKI, and lipids accumulate in the renal tissue itself. The consequences of exogenous fatty acid intake depend on the structural characteristics of the metabolites applied, as well as on the pattern of renal damage and the relevant pathophysiological processes. Conclusions Under certain conditions, adequate fatty acid oxidation may be considered nephroprotective; however, the complexity of the syndrome’s pathophysiology must always be taken into account. Distinct fatty acids have the potential to offer therapeutic benefits in AKI cases. However, the efficacy of an FA-based therapeutic approach depends on two main factors: the chemical structure of the substances used and the nature of the underlying kidney disease.