Unlocking new frontiers in kidney diseases: targeting endothelial dysfunction with emerging biomarkers and therapies

Abstract

Kidney diseases are a global health concern with increasing morbidity and mortality. Their progression involves multiple pathological mechanisms, including inflammation, oxidative stress, apoptosis, glomerulosclerosis, fibrosis, renin–angiotensin–aldosterone system (RAAS) activation, and endothelial dysfunction. The endothelin (ET) system has a key role in vascular homeostasis, and its dysfunction is linked to kidney diseases. However, few endothelial dysfunction biomarkers and therapeutic targets have been identified. In this review, we explore emerging biomarkers, such as endoglin, periostin, fetuin-A, endocan, cytokeratin (CK)-18, and others, highlighting their diagnostic and therapeutic potential. Identifying these biomarkers could advance novel therapeutic strategies for effective kidney disease management in preclinical and clinical settings.