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This review delves into the vicious cycle triggered by intestinal barrier disruption and dysbiosis in SA-AKI: pathogenic translocation, immune cell infiltration, and imbalances in nephrotoxic metabolites collectively drive renal inflammatory storms. Building upon these mechanisms, we systematically evaluate novel therapeutic approaches centred on microecological modulation, targeted anti-inflammatory immunotherapy, traditional Chinese medicine interventions, and vagus nerve electrical stimulation. These strategies aim to pioneer new pathways for the precise prevention and treatment of SA-AKI.<\/jats:p>","DOI":"10.3389\/fphar.2026.1878375","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T07:52:01Z","timestamp":1787039521000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Research advances on the gut-kidney axis theory in sepsis-associated acute kidney injury"],"prefix":"10.3389","volume":"17","author":[{"given":"Min","family":"Li","sequence":"first","affiliation":[{"name":"Emergency Intensive Care Unit, First Hospital of Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Long","family":"He","sequence":"additional","affiliation":[{"name":"Emergency Intensive Care Unit, First Hospital of Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Chen","sequence":"additional","affiliation":[{"name":"Emergency Intensive Care Unit, First Hospital of Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng-Zhong","family":"Fang","sequence":"additional","affiliation":[{"name":"Emergency Intensive Care Unit, First Hospital of Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Feng","sequence":"additional","affiliation":[{"name":"Emergency Intensive Care Unit, First Hospital of Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian-Kui","family":"Shuai","sequence":"additional","affiliation":[{"name":"Emergency Intensive Care Unit, First Hospital of Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Ping","family":"Liu","sequence":"additional","affiliation":[{"name":"Emergency Intensive Care Unit, First Hospital of Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3359","DOI":"10.1074\/jbc.ra118.005103","article-title":"Bile acid analogues are activators of pyrin inflammasome","volume":"294","author":"Alimov","year":"2019","journal-title":"J. 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