Biomedicines

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Dear Colleagues,

Chronic kidney disease (CKD) is characterized by numerous metabolic disorders and comorbidities that increase the risk of its progression toward end-stage renal disease (ESRD) and the mortality risk, worsening the patient's quality of life. These comorbidities include diabetes mellitus, arterial hypertension, protein energy wasting, mineral bone disorders, metabolic acidosis, hyperhomocysteinemia, uremic sarcopenia, uremic gastropathy, normochromic and normocytic anemia, electrolyte imbalance, dyslipidemia and gut dysbiosis. In this context, the identification and use of new pharmacological treatments are of particular relevance for the clinical management of CKD patients.

The purpose of our Special Issue is to take stock of the most innovative pharmacological and non-pharmacological therapies that employ a holistic approach to treating CKD patients.

Prof. Annalisa Noce
Dr. Manuela Di Lauro
Guest Editors

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Keywords

natural bioactive compounds
adjuvant treatment
protein energy wasting
mineral bone disorders
metabolic acidosis
hyperhomocysteinemia
uremic sarcopenia
PLADO diet
anemia in CKD

Published Papers (1 paper)

Review

24 pages, 1527 KiB

Open AccessReview

Innovative Treatments to Counteract Endothelial Dysfunction in Chronic Kidney Disease Patients

by Giulia Marrone, Kevin Cornali, Manuela Di Lauro, Maria Josè Ceravolo, Luca Di Marco, Simone Manca di Villahermosa, Anna Paola Mitterhofer and Annalisa Noce

Biomedicines 2024, 12(5), 1085; https://doi.org/10.3390/biomedicines12051085 - 14 May 2024

Viewed by 321

Abstract

In chronic kidney disease (CKD) patients, several risk factors contribute to the development of endothelial dysfunction (ED), which can be described as an alteration in the cell structure or in the function of the endothelium. Among the well-known CKD-related risk factors capable of altering the production of endothelium-derived relaxing factors, we include asymmetric dimethylarginine increase, reduced dimethylarginine dimethylamine hydrolase enzyme activity, low-grade chronic systemic inflammation, hyperhomocysteinemia, oxidative stress, insulin resistance, alteration of calcium phosphorus metabolism, and early aging. In this review, we also examined the most important techniques useful for studying ED in humans, which are divided into indirect and direct methods. The direct study of coronary endothelial function is considered the gold standard technique to evaluate if ED is present. In addition to the discussion of the main pharmacological treatments useful to counteract ED in CKD patients (namely sodium–glucose cotransporter 2 inhibitors and mineralocorticoid receptor antagonist), we elucidate innovative non-pharmacological treatments that are successful in accompanying the pharmacological ones. Among them, the most important are the consumption of extra virgin olive oil with high intake of minor polar compounds, adherence to a plant-dominant, low-protein diet (LPD), an adaptive physical activity program and, finally, ketoanalogue administration in combination with the LPD or the very low-protein diet. Full article

(This article belongs to the Special Issue Pharmaceutical Treatments for Typical CKD Comorbidities)

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