Chronic kidney disease and vascular remodelling: molecular mechanisms and clinical implications

Area of Science:

• Nephrology
• Cardiology
• Vascular Biology

Background:

• Chronic kidney disease (CKD) is highly prevalent and strongly associated with cardiovascular (CV) complications.
• CKD patients experience hemodynamic disturbances and metabolic abnormalities, promoting arterial remodelling and CV disease.
• Arterial calcification, a key aspect of remodelling, is linked to mineral metabolism issues in CKD.

Purpose of the Study:

• To review the mechanisms underlying arterial calcification and remodelling in CKD.
• To explore the role of various molecular pathways in CKD-associated arterial changes.
• To discuss the clinical impact of arterial stiffness and remodelling in CKD patients.

Main Methods:

• Literature review of mechanisms in arterial calcification and remodelling in CKD.
• Analysis of factors contributing to arterial wall modifications.
• Examination of clinical consequences of arterial stiffness.

Main Results:

• CKD involves specific arterial remodelling driven by metabolic and hemodynamic factors.
• Arterial calcification is a significant event linked to mineral metabolism abnormalities.
• Multiple pathways including renin-angiotensin system, endothelin-1, and Klotho are implicated.

Conclusions:

• CKD significantly alters arterial structure and function, leading to increased CV risk.
• Understanding these complex mechanisms is vital for therapeutic strategies in CKD.
• Arterial stiffness and remodelling contribute to the high CV morbidity and mortality in CKD.