The systemic nature of CKD.

Area of Science:

• Nephrology
• Systems Biology
• Genomics

Background:

• Chronic kidney disease (CKD) definition and staging are key nephrology advancements.
• Previous research on CKD's organ interactions used a limited, two-organ approach due to technological constraints.
• Emerging evidence points to CKD's complex, systemic nature involving integrated biological processes.

Purpose of the Study:

• To highlight the complex and systemic nature of chronic kidney disease.
• To discuss how a diseased kidney disrupts integrated biological systems.
• To advocate for a systems biology approach to study CKD pathophysiology.

Main Methods:

• Review of experimental and clinical studies from the last two decades.
• Analysis of organ interactions, focusing on energy balance, innate immunity, and neuroendocrine signaling.
• Discussion of omics techniques for a systems biology approach.

Main Results:

• CKD disrupts integrated biological systems, leading to a high-risk phenotype.
• This phenotype includes inflammation, protein-energy wasting, and nervous system dysfunction.
• CKD is associated with cardiopulmonary, vascular, and bone diseases.

Conclusions:

• CKD is a systemic disease with widespread effects beyond the kidneys.
• A systems biology approach is crucial for understanding CKD's complex pathophysiology.
• Targeting disrupted pathways identified through systems biology may lead to novel CKD prevention and therapies.