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Beyond Blood Pressure: Emerging Pathways and Precision Approaches in Hypertension-Induced Kidney Damage

Charlotte Delrue1, Marijn M Speeckaert1,2

  • 1Department of Nephrology, Ghent University Hospital, 9000 Ghent, Belgium.

International Journal of Molecular Sciences
|August 14, 2025
PubMed

Insights

Hypertensive kidney injury involves complex cellular and genetic factors beyond high blood pressure. Precision medicine, using omics and genetic insights, offers personalized treatments for better patient care and outcomes.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Genetics

Background:

  • Hypertensive kidney injury stems from elevated blood pressure and intricate cellular, molecular, and genetic interactions.
  • Key pathways include renin-angiotensin system (RAS) dysregulation, oxidative stress, inflammation, metabolic issues, epigenetics, and genetic predispositions.

Purpose of the Study:

  • To review emerging pathways contributing to kidney damage in hypertension.
  • To discuss precision medicine strategies for managing hypertensive kidney disease.

Main Methods:

  • Integrative review of recent studies on hypertensive kidney injury.
  • Analysis of cellular, molecular, genetic, and epigenetic mechanisms.
  • Evaluation of precision medicine approaches and omics technologies.

Main Results:

  • Identified dysregulated RAS, oxidative stress, inflammation, metabolic abnormalities, epigenetic changes, and genetic factors as key contributors.
  • Highlighted precision medicine strategies including biomarker-directed and pharmacologically targeted therapies.
  • Emphasized the role of omics technologies and genetic guidance in patient stratification.

Conclusions:

  • Hypertensive kidney disease is multifactorial, involving complex biological pathways.
  • Precision medicine and omics technologies are crucial for personalized treatment and improved patient outcomes.
Keywords:
hypertensive kidney diseasepathwaysrenin–angiotensin–aldosterone system

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