While extensive research using animal models has improved the understanding of acute
kidney injury (AKI), this knowledge has not been translated into effective treatments.
Many promising interventions for AKI identified in mice and rats have not been validated
in subsequent clinical trials. As a result, the mortality rate of AKI patients remains
high. Inflammation plays a fundamental role in the pathogenesis of AKI, and one reason for
the failure to translate promising therapeutics may lie in the profound difference between
the immune systems of rodents and humans. The immune systems of large animals such as
swine, nonhuman primates, sheep, dogs and cats, more closely resemble the human immune
system. Therefore, in the absence of a basic understanding of the pathophysiology of human
AKI, large animals are attractive models to test novel interventions. However, there is a
lack of reviews on large animal models for AKI in the literature. In this review, we will
first highlight differences in innate and adaptive immunities among rodents, large
animals, and humans in relation to AKI. After illustrating the potential merits of large
animals in testing therapies for AKI, we will summarize the current state of the evidence
in terms of what therapeutics have been tested in large animal models. The aim of this
review is not to suggest that murine models are not valid to study AKI. Instead, our
objective is to demonstrate that large animal models can serve as valuable and
complementary tools in translating potential therapeutics into clinical practice.