Methods and potential biomarkers for the evaluation of endothelial dysfunction in chronic kidney disease: a critical...

Area of Science:

• Nephrology
• Cardiovascular Medicine
• Vascular Biology

Background:

• Chronic kidney disease (CKD) is linked to significant cardiovascular morbidity and mortality.
• Endothelial dysfunction (ED), arterial stiffness, and vascular calcifications are key contributors to cardiovascular events in CKD.
• Vascular abnormalities in CKD patients are often more severe than in other high-risk groups and typically go undiagnosed.

Purpose of the Study:

• To review the causes and risk factors of ED, oxidative stress, and inflammation in CKD.
• To describe methods for investigating ED and the role of biomarkers.
• To discuss the diagnostic and therapeutic implications of novel ED markers in CKD.

Main Methods:

• Review of literature on causes, risk factors, and investigation of ED in CKD.
• Description of methods including plethysmography, laser Doppler, Doppler ultrasound, and applanation tonometry.
• Discussion of biomarkers and clinical assessment tools for ED and arterial stiffness.

Main Results:

• ED, arterial stiffness, and vascular calcifications are major drivers of cardiovascular complications in CKD.
• Standard clinical settings often miss the diagnosis of abnormal vascular reactivity in CKD.
• Applanation tonometry offers a reliable bedside assessment of arterial stiffness and vascular reactivity.

Conclusions:

• A comprehensive assessment combining biomarkers and bedside investigational approaches is needed for ED in CKD.
• Improving endothelial function remains a significant clinical challenge with limited therapeutic options.
• Developing optimal therapeutic tools requires a multi-faceted diagnostic strategy.