Feng Liang, Gui Li, Kehong Chen, Jia Chen, Junling He, Yani He
{"title":"慢性肾脏疾病的内皮功能障碍及治疗进展","authors":"Feng Liang, Gui Li, Kehong Chen, Jia Chen, Junling He, Yani He","doi":"10.1002/dmrr.70086","DOIUrl":null,"url":null,"abstract":"<p>Chronic kidney disease (CKD) substantially increases cardiovascular risk, with endothelial dysfunction as its central pathological mechanism. This review summarises the molecular regulatory mechanisms underlying endothelial dysfunction in CKD and highlights recent advances in treatment strategies. The pathophysiology of endothelial injuries involves a complex network of multiple factors and mechanisms, including oxidative stress, inflammation, glycocalyx damage, ischaemia, hypoxia, cellular senescence and endothelial-mesenchymal transition (EndMT). Recent advances have yielded several promising CKD treatment strategies, including dual endothelin-angiotensin receptor antagonists (DEARA), dipeptidyl peptidase-4 inhibitors (DPP-4i), glucagon-like peptide-1 receptor agonists (GLP-1RA), renin-angiotensin-aldosterone system inhibitors (RAASi), sodium-glucose cotransporter 2 inhibitors (SGLT2i) and mineralocorticoid receptor antagonists (MRA), which have demonstrated favourable protective effects on endothelial cells. Moreover, emerging anti-ageing therapies are novel therapeutic directions for research related to endothelial protection. In future studies, the synergistic effects of nonpharmacological interventions (such as lifestyle modifications and nutritional support) and pharmacological therapies will be a new direction, providing ideas for improving endothelial dysfunction, decelerating the progression of CKD, reducing the risk of cardiovascular events, and ultimately improving patient outcomes.</p>","PeriodicalId":11335,"journal":{"name":"Diabetes/Metabolism Research and Reviews","volume":"41 6","pages":""},"PeriodicalIF":6.0000,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70086","citationCount":"0","resultStr":"{\"title\":\"Endothelial Dysfunction and Therapeutic Advances in Chronic Kidney Disease\",\"authors\":\"Feng Liang, Gui Li, Kehong Chen, Jia Chen, Junling He, Yani He\",\"doi\":\"10.1002/dmrr.70086\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>Chronic kidney disease (CKD) substantially increases cardiovascular risk, with endothelial dysfunction as its central pathological mechanism. This review summarises the molecular regulatory mechanisms underlying endothelial dysfunction in CKD and highlights recent advances in treatment strategies. The pathophysiology of endothelial injuries involves a complex network of multiple factors and mechanisms, including oxidative stress, inflammation, glycocalyx damage, ischaemia, hypoxia, cellular senescence and endothelial-mesenchymal transition (EndMT). Recent advances have yielded several promising CKD treatment strategies, including dual endothelin-angiotensin receptor antagonists (DEARA), dipeptidyl peptidase-4 inhibitors (DPP-4i), glucagon-like peptide-1 receptor agonists (GLP-1RA), renin-angiotensin-aldosterone system inhibitors (RAASi), sodium-glucose cotransporter 2 inhibitors (SGLT2i) and mineralocorticoid receptor antagonists (MRA), which have demonstrated favourable protective effects on endothelial cells. Moreover, emerging anti-ageing therapies are novel therapeutic directions for research related to endothelial protection. In future studies, the synergistic effects of nonpharmacological interventions (such as lifestyle modifications and nutritional support) and pharmacological therapies will be a new direction, providing ideas for improving endothelial dysfunction, decelerating the progression of CKD, reducing the risk of cardiovascular events, and ultimately improving patient outcomes.</p>\",\"PeriodicalId\":11335,\"journal\":{\"name\":\"Diabetes/Metabolism Research and Reviews\",\"volume\":\"41 6\",\"pages\":\"\"},\"PeriodicalIF\":6.0000,\"publicationDate\":\"2025-09-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dmrr.70086\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetes/Metabolism Research and Reviews\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/dmrr.70086\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes/Metabolism Research and Reviews","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/dmrr.70086","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Endothelial Dysfunction and Therapeutic Advances in Chronic Kidney Disease
Chronic kidney disease (CKD) substantially increases cardiovascular risk, with endothelial dysfunction as its central pathological mechanism. This review summarises the molecular regulatory mechanisms underlying endothelial dysfunction in CKD and highlights recent advances in treatment strategies. The pathophysiology of endothelial injuries involves a complex network of multiple factors and mechanisms, including oxidative stress, inflammation, glycocalyx damage, ischaemia, hypoxia, cellular senescence and endothelial-mesenchymal transition (EndMT). Recent advances have yielded several promising CKD treatment strategies, including dual endothelin-angiotensin receptor antagonists (DEARA), dipeptidyl peptidase-4 inhibitors (DPP-4i), glucagon-like peptide-1 receptor agonists (GLP-1RA), renin-angiotensin-aldosterone system inhibitors (RAASi), sodium-glucose cotransporter 2 inhibitors (SGLT2i) and mineralocorticoid receptor antagonists (MRA), which have demonstrated favourable protective effects on endothelial cells. Moreover, emerging anti-ageing therapies are novel therapeutic directions for research related to endothelial protection. In future studies, the synergistic effects of nonpharmacological interventions (such as lifestyle modifications and nutritional support) and pharmacological therapies will be a new direction, providing ideas for improving endothelial dysfunction, decelerating the progression of CKD, reducing the risk of cardiovascular events, and ultimately improving patient outcomes.
期刊介绍:
Diabetes/Metabolism Research and Reviews is a premier endocrinology and metabolism journal esteemed by clinicians and researchers alike. Encompassing a wide spectrum of topics including diabetes, endocrinology, metabolism, and obesity, the journal eagerly accepts submissions ranging from clinical studies to basic and translational research, as well as reviews exploring historical progress, controversial issues, and prominent opinions in the field. Join us in advancing knowledge and understanding in the realm of diabetes and metabolism.