ACTH prophylactic treatment of renal disorders

1. A method of prophylactically treating acute kidney injury (AKI) in an individual in need thereof, comprising selecting an individual suspected of having, predisposed to, or at risk of developing acute kidney injury, and administering an adrenocorticotropic hormone (ACTH) peptide and a second therapeutic agent to the individual in need thereof, wherein the ACTH peptide is administered as a first dose and one or more subsequent doses, and wherein the ACTH peptide is an ACTH peptide preparation comprising ACTH peptides having about 90% or greater sequence identity with a full-length porcine ACTH sequence, wherein amino acids 1-13 of the ACTH peptide are amino acids 1-13 of SEQ ID NO: 1.

2. The method of claim 1 , wherein the ACTH peptides in the preparation are derived from porcine pituitary glands.

3. The method of claim 1 , wherein the ACTH peptide preparation is formulated in a gel.

4. The method of claim 1 , wherein the individual is undergoing surgery or has sepsis.

5. The method of claim 1 , wherein the selection of the individual is based upon a change in a kidney biomarker in the individual as compared to a normal baseline level of the kidney biomarker in the general population.

6. The method of claim 1 , wherein the selection of an individual is based upon a decrease in a glomerular filtration rate (GFR) level as compared to a normal baseline level, an increase in a serum creatinine level as compared to a normal baseline level, an increase in a urinary protein level as compared to a normal baseline level, an elevated asymmetric dimethylarginine (ADMA) level as compared to a normal baseline level, an elevated cystatin C (CysC) level as compared to a normal baseline level, an elevated C-reactive Protein (CRP) level as compared to a normal baseline level, or an elevated soluble tumor necrosis factor receptor II (sTNFrii) level as compared to a normal baseline level.

7. The method of claim 1 , wherein the selection of an individual is based upon detection of urinary neutrophil gelatinase-associated lipocalin (NGAL), detection of urinary interleukin-18 (IL-18), urinary kidney injury molecule-1 (KIM-1), or decreased urine output.

8. The method of claim 1 , wherein the first dose of the ACTH peptide preparation comprises a dose between about 10 IU and about 150 IU, and the one or more subsequent doses of the ACTH peptide preparation is administered about every day, about every 2 days, about every 5 days, about every week, about every two weeks, about every three weeks, about every month, about every two months, or any combination thereof.

9. The method of claim 1 , wherein the first dose of the ACTH peptide preparation comprises a dose between about 10 IU and about 150 IU, and the one or more subsequent doses of the ACTH peptide preparation are between about 20%-80% of the first dose.

10. The method of claim 1 , wherein the first dose of the ACTH peptide preparation comprises a first dose of between about 10 IU and about 150 IU, and the one or more subsequent doses of the ACTH peptide preparation are between about 20%-60% of the first dose.

11. The method of claim 1 , wherein the first dose and the one or more subsequent doses of the ACTH peptide preparation comprises a first dose of between about 10 IU and about 150 IU, and the one or more subsequent doses of the ACTH peptide preparation are between about 10 IU and about 80 IU, the first dose and the one or more subsequent doses of the ACTH peptide preparation are intermittent.

12. The method of claim 1 , wherein the second therapeutic agent is selected from the group consisting of an angiotensin-converting enzyme inhibitor, an angiotensin receptor blocker, a phosphate binder, a hepatocyte growth factor (HGF), a corticosteroid, erythropoietin, calcitriol, bardoxolone methyl, medoxomil, sulodexide and avosentan.

13. A method of treating renal damage caused by ischemia to the kidney in an individual in need thereof, comprising administering to the individual in need thereof an adrenocorticotropic hormone (ACTH) as an ACTH peptide preparation and a second therapeutic agent, wherein the ACTH peptide preparation has about 90% or greater sequence identity with a full-length porcine ACTH sequence, wherein amino acids 1-13 of the ACTH peptide are amino acids 1-13 of SEQ ID NO: 1, and wherein the ACTH peptide preparation is administered as a first dose and one or more subsequent doses.

14. The method of claim 13 , wherein the ACTH peptide preparation is formulated in a gel.

15. Previously presented) The method of claim 13 , wherein the second therapeutic agent is selected from the group consisting of an angiotensin-converting enzyme inhibitor, an angiotensin receptor blocker, a phosphate binder, a hepatocyte growth factor (HGF), a corticosteroid, erythropoietin, calcitriol, bardoxolone methyl, medoxomil, sulodexide and avosentan.