New Insights in the Pathogenesis and Treatment of Chronic Kidney Disease and Its Complications

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 30 September 2024 | Viewed by 2638

Special Issue Editor


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Guest Editor
Nephrology Dept. at the “Dr. Carol Davila” Teaching Hospital of Nephrology, “Carol Davila” University of Medicine and Pharmacy, 010731 București, Romania
Interests: chronic kidney disease; oxidative stress; renal anemia; intravenous iron; CKD-related mineral and bone disorders; kidney biopsy in glomerular diseases
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Special Issue Information

Dear Colleagues,

Chronic kidney disease remains a global health challenge generated by a wide variety of causes, and can present either as primitive diseases of the kidneys or have secondary involvement in various systemic diseases. Consequently, the underlying mechanisms of the tisular lesions are very different, making it more difficult to comprehensively understand the pathogenesis of primary nephropathies, an essential step for applying adequate therapeutic strategies to halt or, at least delay, the progression of chronic kidney disease. Recently, a myriad of research has underscored the roles of complement and inflammation in the occurrence of glomerular diseases, and started to decipher the mechanisms of kidney fibrosis during renal pathologies. Both of these research directions are expected to open up new insights into CKD pathogenesis and, hopefully, to provide a rationale for future effective therapeutic interventions.

Moreover, irrespective of the primary nephropathy, the main features of CKD—albuminuria and a decline in the glomerular filtration rate—were associated with a wide range of complications, from heart and brain pathologies to hematologic and mineral metabolism disorders. Despite their huge impact on the quality of life and outcome of patients with kidney diseases, the pathogenesis of the most CKD-related complications is also complex and not completely understood. Therapeutic advances have been made in this respect as well, at least in the field of cardiovascular protection, while other complications are still waiting for breakthrough discoveries.

Therefore, as a continuation of Biomedicines’ mission to provide updated information on specific topics, it is my pleasure to invite all interested researchers to share with readers their novel data in the above mentioned fields through this Special Issue.

Dr. Cristina Capusa
Guest Editor

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Keywords

  • complement-mediated glomerulopathies
  • cardiovascular diseases
  • chronic kidney disease
  • mechanisms of kidney fibrosis
  • mineral metabolism abnormalities
  • neurologic disorders
  • renal anemia
  • vascular calcifications
  • therapeutic strategies to reduce CKD progression

Published Papers (1 paper)

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Review

22 pages, 3205 KiB  
Review
Nephrotic Syndrome: From Pathophysiology to Novel Therapeutic Approaches
by Valentina-Georgiana Frățilă, Gabriela Lupușoru, Bogdan Marian Sorohan, Bogdan Obrișcă, Valentin Mocanu, Mircea Lupușoru and Gener Ismail
Biomedicines 2024, 12(3), 569; https://doi.org/10.3390/biomedicines12030569 - 3 Mar 2024
Viewed by 2392
Abstract
Nephrotic edema stands out as one of the most common complications of nephrotic syndrome. The effective management of hypervolemia is paramount in addressing this condition. Initially, “the underfill hypothesis” suggested that proteinuria and hypoalbuminemia led to fluid extravasation into the interstitial space, causing [...] Read more.
Nephrotic edema stands out as one of the most common complications of nephrotic syndrome. The effective management of hypervolemia is paramount in addressing this condition. Initially, “the underfill hypothesis” suggested that proteinuria and hypoalbuminemia led to fluid extravasation into the interstitial space, causing the intravascular hypovolemia and activation of neurohormonal compensatory mechanisms, which increased the retention of salt and water. Consequently, the recommended management involved diuretics and human-albumin infusion. However, recent findings from human and animal studies have unveiled a kidney-limited sodium-reabsorption mechanism, attributed to the presence of various serine proteases in the tubular lumen-activating ENaC channels, thereby causing sodium reabsorption. There is currently no standardized guideline for diuretic therapy. In clinical practice, loop diuretics continue to be the preferred initial choice. It is noteworthy that patients often exhibit diuretic resistance due to various factors such as high-sodium diets, poor drug compliance, changes in pharmacokinetics or pharmacodynamics, kidney dysfunction, decreased renal flow, nephron remodeling and proteasuria. Considering these challenges, combining diuretics may be a rational approach to overcoming diuretic resistance. Despite the limited data available on diuretic treatment in nephrotic syndrome complicated by hypervolemia, ENaC blockers emerge as a potential add-on treatment for nephrotic edema. Full article
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