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Modified 3rd Generation Synchronization Modulation Electric Field (3m-SMEF) Prevents Ischemia-Reperfusion-Induced Acute Kidney Injury via Targeting Na⁺/K⁺-ATPase

Created on 22 Oct 2026

Authors

Hall, N., Zeleznova, N. N., Esquivel, C., Wahbeh, T., Parris, C., Lozonschi, I., Hernandez, N., Wang, L., Chen, W., Liu, R.

Abstract

Acute kidney injury (AKI) caused by ischemia-reperfusion injury (IRI) remains a major clinical problem with limited therapeutic options. We previously demonstrated that the 3rd-generation Synchronization Modulation Electric Field (SMEF) preserves Na/K-ATPase function during ischemia and protects against kidney injury. In the present study, we substantially modified the 3rd-generation SMEF (3m-SMEF) to further improve/optimize Na/K-ATPase regulation and enhance the protective effects, which was tested both in vitro and in vivo. In HK-2 cells, hypoxia/reoxygenation reduced Na/K-ATPase expression and induced apoptotic and necroptotic signaling, whereas 3m-SMEF restored Na/K-ATPase expression and markedly reduced cell death. In vivo, male and female mice underwent unilateral renal ischemia with or without 3m-SMEF treatment during vascular clamping. At 24 h, 3m-SMEF markedly improved renal function, reducing plasma creatinine by ~90-95% and restoring glomerular filtration rate to near-control levels. Application of the 3m-SMEF also normalized kidney injury markers (KIM-1 and NGAL), preserved renal ATP, and prevented the translocation and loss of Na/K-ATPase expression. The renoprotective effects substantially exceeded those achieved with the previous SMEF platform. These findings demonstrate that 3m-SMEF provides robust protection against ischemic AKI by preserving Na/K-ATPase function and tubular integrity and represents a promising non-pharmacological therapy for ischemic kidney injury.

Preprint server: bioRxiv
The authors list and abstract were imported from bioRxiv on 22 Oct 2026.

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