Institute for Molecular Cardiovascular Research (IMCAR), University Hospital RWTH Aachen, Aachen, Germany (C.C.F.M.J.B., S.V., H.N.).
Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands (C.C.F.M.J.B., H.N.).
Circ Res. 2023 Apr 14;132(8):970-992. doi: 10.1161/CIRCRESAHA.123.321752. Epub 2023 Apr 13.
The endothelium is considered to be the gatekeeper of the vessel wall, maintaining and regulating vascular integrity. In patients with chronic kidney disease, protective endothelial cell functions are impaired due to the proinflammatory, prothrombotic and uremic environment caused by the decline in kidney function, adding to the increase in cardiovascular complications in this vulnerable patient population. In this review, we discuss endothelial cell functioning in healthy conditions and the contribution of endothelial cell dysfunction to cardiovascular disease. Further, we summarize the phenotypic changes of the endothelium in chronic kidney disease patients and the relation of endothelial cell dysfunction to cardiovascular risk in chronic kidney disease. We also review the mechanisms that underlie endothelial changes in chronic kidney disease and consider potential pharmacological interventions that can ameliorate endothelial health.
内皮细胞被认为是血管壁的守门员，维持和调节血管完整性。在慢性肾脏病患者中，由于肾功能下降导致的促炎、促血栓形成和尿毒症环境，保护性内皮细胞功能受损，使这一脆弱患者群体的心血管并发症增加。在这篇综述中，我们讨论了内皮细胞在健康状态下的功能以及内皮细胞功能障碍对心血管疾病的贡献。此外，我们总结了慢性肾脏病患者内皮细胞的表型变化以及内皮细胞功能障碍与慢性肾脏病心血管风险的关系。我们还回顾了慢性肾脏病中内皮变化的潜在机制，并考虑了潜在的改善内皮健康的药物干预措施。
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