Εndothelial and microvascular function in CKD: Evaluation methods and associations with outcomes

Area of Science:

• Nephrology
• Cardiology
• Vascular Biology

Background:

• Cardiovascular disease (CVD) is a primary cause of death in chronic kidney disease (CKD) patients.
• Endothelial dysfunction, a key feature of atherosclerosis, is implicated in the progression of both cardiovascular and kidney diseases in this population.

Purpose of the Study:

• To review techniques and markers for assessing microvascular and endothelial function in CKD patients.
• To discuss the link between endothelial dysfunction and co-morbidities, and outcomes in CKD.

Main Methods:

• Narrative review of studies on endothelial function assessment in CKD.
• Inclusion of techniques like Venous Occlusion Plethysmography, Flow-Mediated Dilatation, Near-Infrared Spectroscopy, and Laser Speckle Contrast Analysis.
• Consideration of circulating biomarkers for endothelial function evaluation.

Main Results:

• Endothelial dysfunction is an early finding in CKD.
• It contributes to target organ damage, cardiovascular events, mortality, and progression to end-stage kidney disease.
• Multiple functional methods and biomarkers confirm these associations.

Conclusions:

• Established and novel methods, along with biomarkers, demonstrate endothelial dysfunction in CKD.
• Evidence strongly supports the association of endothelial dysfunction with adverse outcomes in CKD patients.
• Future research should focus on non-invasive methods to further clarify its role in disease progression.