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The therapeutic potential of apelin in kidney disease

Fiona A Chapman1,2, Duuamene Nyimanu3, Janet J Maguire3

  • 1BHF/University Centre for Cardiovascular Science, The Queen's Medical Research Institute, Edinburgh, UK.

Nature Reviews. Nephrology
|August 14, 2021
PubMed

Insights

The apelin system, a natural regulator, shows promise for treating chronic kidney disease (CKD). Targeting apelin may offer new therapeutic strategies for kidney disease and associated cardiovascular risks.

Area of Science:

  • Nephrology
  • Cardiovascular Disease
  • Endocrinology

Background:

  • Chronic kidney disease (CKD) significantly contributes to global mortality and cardiovascular complications.
  • Current treatments, primarily renin-angiotensin-aldosterone system (RAAS) blockade, are insufficient to prevent CKD progression to kidney failure.
  • The apelin system, an endogenous regulator, is recognized for its physiological roles and therapeutic potential.

Purpose of the Study:

  • To explore the potential of the apelin system as a therapeutic target for chronic kidney disease.
  • To review the known functions of the apelin system in cardiovascular and renal physiology.
  • To assess the protective effects of apelin in preclinical kidney injury models.

Main Methods:

  • Review of preclinical and clinical studies on the apelin system and its ligands (apelin, elabela/toddler).
  • Analysis of the apelin system's interaction with the renin-angiotensin-aldosterone system (RAAS).
  • Examination of apelin's effects on glomerular hemodynamics, tubular function, and kidney injury models.

Main Results:

  • Apelin receptor ligands are endothelium-dependent vasodilators and inotropes.
  • The apelin system exhibits a reciprocal relationship with the RAAS.
  • Preclinical data indicate apelin regulates renal hemodynamics, promotes aquaresis, and offers protection in kidney injury models.

Conclusions:

  • The apelin system demonstrates significant potential as a therapeutic target for kidney disease.
  • Apelin's multifaceted roles in cardiovascular and renal function warrant further investigation in CKD patients.
  • Targeting the apelin system could offer novel treatment strategies for managing CKD and its complications.

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