Acute kidney injury (AKI) is a common and serious disease entity that affects native kidneys and allografts but for which no specific treatments exist. Complex intrarenal inflammatory processes driven by lymphocytes and innate immune cells have key roles in the development and progression of AKI. Many studies have focused on prevention of early injury in AKI. However, most patients with AKI present after injury is already established. Increasing research is therefore focusing on mechanisms of renal repair following AKI and prevention of progression from AKI to chronic kidney disease. CD4⁺ and CD8⁺ T cells, B cells and neutrophils are probably involved in the development and progression of AKI, whereas regulatory T cells, double-negative T cells and type 2 innate lymphoid cells have protective roles. Several immune cells, such as macrophages and natural killer T cells, can have both deleterious and protective effects, depending on their subtype and/or the stage of AKI. The immune system not only participates in injury and repair processes during AKI but also has a role in mediating AKI-induced distant organ dysfunction. Targeted manipulation of immune cells is a promising therapeutic strategy to improve AKI outcomes.

急性肾损伤 （AKI） 是一种常见且严重的疾病实体，会影响自体肾脏和同种异体移植物，但尚无特异性治疗方法。由淋巴细胞和先天免疫细胞驱动的复杂肾内炎症过程在 AKI 的发生和进展中起关键作用。许多研究都集中在预防 AKI 的早期损伤上。然而，大多数受伤后出现的 AKI 患者已经确诊。因此，越来越多的研究集中在 AKI 后肾脏修复的机制和预防从 AKI 进展为慢性肾病。CD4⁺ 和 CD8⁺ T 细胞、B 细胞和中性粒细胞可能参与 AKI 的发生和进展，而调节性 T 细胞、双阴性 T 细胞和 2 型先天淋巴细胞具有保护作用。几种免疫细胞，如巨噬细胞和自然杀伤 T 细胞，可以同时具有有害和保护作用，具体取决于它们的亚型和/或 AKI 的阶段。免疫系统不仅参与 AKI 期间的损伤和修复过程，而且还在介导 AKI 诱导的远处器官功能障碍中发挥作用。免疫细胞的靶向操作是改善 AKI 结果的一种有前途的治疗策略。