Cardiac and Renal Fibrosis, the Silent Killer in the Cardiovascular Continuum: An Up-to-Date

Area of Science:

• Nephrology
• Cardiology
• Fibrosis Research

Background:

• Cardiovascular disease (CVD) and chronic kidney disease (CKD) frequently coexist, significantly impacting patient outcomes.
• Organ fibrosis is a key factor in cardio-renal syndrome (CRS) pathogenesis, leading to high rates of heart failure and sudden cardiac death.
• Mechanisms include hemodynamic changes, renin-angiotensin-aldosterone system (RAAS) activation, FGF23, Klotho protein, and collagen deposition.

Purpose of the Study:

• To review the molecular mechanisms underlying cardiac and renal fibrosis in patients with CKD and heart failure (HF).
• To highlight emerging therapeutic targets and alternative strategies for managing cardio-renal fibrosis.

Main Methods:

• Literature review focusing on molecular mechanisms of fibrosis in CKD and HF.
• Analysis of proposed mediators and pathways contributing to fibroblast and collagen turnover.
• Identification of novel therapeutic targets and agents.

Main Results:

• Fibrosis significantly contributes to the progression of cardio-renal syndrome.
• Multiple molecular pathways, including RAAS, FGF23, and Klotho, are implicated in cardiac and renal fibrosis.
• Several novel therapeutic strategies are under investigation.

Conclusions:

• Understanding the molecular basis of fibrosis is crucial for managing patients with coexisting CVD and CKD.
• Targeting specific fibrotic pathways offers promising therapeutic avenues for cardio-renal conditions.
• Further research into novel agents like RAAS inhibitors, serelaxin, and IL-11 antibodies is warranted.