Research progress on histone deacetylases in peritoneal dialysis-associated peritoneal fibrosis

When chronic kidney disease (CKD) progresses to end-stage renal disease (ESRD), peritoneal dialysis (PD) can serve as an effective alternative therapy, but it also has its limitations. Peritoneal fibrosis (PF), a PD-related complication, is one of the major and serious complications of long-term PD that can lead to ultrafiltration failure, severely impacting the efficacy of PD treatment. At present, most of the research on the molecular mechanisms of fibrosis focuses on the liver and kidney, but there is relatively little research on PF for identifying anti-fibrotic targets. Histone deacetylase (HDAC), as an enzyme that exerts transcriptional regulation through deacetylation, when activated can lead to the occurrence and development of inflammation and fibrosis. This review aims to assess the effects of HDAC and HDAC inhibitors on peritoneal inflammation and fibrosis in PF. Therefore, we reviewed the recent progress in PF treatment, focusing on understanding the characteristics and functions of HDAC and their interactions with the extracellular matrix in PF progression, and explored the crucial role of HDAC in regulating fibrosis regression. Additionally, we explored future research directions to identify potential methods for treating PF.