ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: SA-PO0143

NAD+ Boosting Is Protective in the Murine Model of Heme Protein-Mediated AKI (HP-AKI)

Session Information

  • AKI: Mechanisms - 3
    November 08, 2025 | Location: Exhibit Hall, Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

  • 103 AKI: Mechanisms

Authors

  • Croatt, Anthony J., Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States
  • Singh, Raman Deep, Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States
  • Ackerman, Allan W., Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States
  • Grande, Joseph P., Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States
  • Nath, Karl A., Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States
Background

Our prior study showed that renal NAD+ content is reduced following heme-mediated acute kidney injury (HP-AKI) [Kidney360. 15;3(10):1672-1682, 2022]. As NAD+ deficiency has been shown to have a pathogenetic role in other AKI models, we now investigate whether NAD+ boosting is protective in this model.

Methods

HP-AKI was induced in mice by intramuscular injection of hypertonic glycerol. The NAD+ precursor nicotinamide mononucleotide (NMN) was administered daily from 2 days prior to, until 1 day after HP-AKI induction. Renal function was assessed by serum creatinine and BUN, and renal injury was assessed by histologic examination. NAD+ levels and gene/protein expression were also evaluated.

Results

One day after HP-AKI induction, mice treated with NMN had a significantly lower serum creatinine and BUN compared with vehicle-treated mice (2.6±0.1 vs 0.8±0.2 mg/dL, P<0.0001 and 139±7 vs 69±15 mg/dL, P=0.0014, respectively). At this time point after HP-AKI, semiquantitative scoring of histologic injury showed that NMN-treated mice displayed significantly less renal injury compared with vehicle-treated mice as assessed by 5 established indices (range: 58% to 77% reduction). Our studies confirmed that renal NAD+ levels are reduced (61%) in the HP-AKI model at 1 day, and that NMN treatment significantly boosted NAD+ levels in this model compared with vehicle-treated mice (93.2±5.7 vs 39.0±4.4 nmol/mg kidney, P<0.001). Analysis of renal gene and protein expression revealed that at one day after HP-AKI, mice treated with NMN had significantly lower expression of markers of inflammation (PAI1, IL6) and apoptosis (BAX/BCL2, cleaved caspase3), and significantly preserved mitochondrial viability/integrity markers (NRF-1, p-AMPK) compared with vehicle-treated mice.

Conclusion

As in our prior study, we confirm that NAD+ levels are significantly reduced in the HP-AKI model, and we now demonstrate that NMN administration preserves NAD+ levels, with a concomitant protection against acute kidney injury. We also show that NMN treatment protects mitochondria and reduces inflammation and apoptosis. The present data indicate that the NAD+ boosting effect of NMN reduces inflammation and apoptosis in this model, likely through preservation of mitochondrial integrity. Collectively, these findings uncover the protective effects of this treatment in HP-AKI.

Funding

  • NIDDK Support

Digital Object Identifier (DOI)