Departamento de Biología de Sistemas, Universidad de Alcalá (IRYCIS), Alcalá de Henares (Madrid), Spain.
Departamento de Biología de Sistemas, Universidad de Alcalá (IRYCIS), Alcalá de Henares (Madrid), Spain.
Nefrologia (Engl Ed). 2023 Jan-Feb;43(1):63-80. doi: 10.1016/j.nefroe.2023.05.014. Epub 2023 May 31.
Chronic kidney disease (CKD) is a pathology with a high worldwide incidence and an upward trend affecting the elderly. When CKD is very advanced, the use of renal replacement therapies is required to prolong its life (dialysis or kidney transplantation). Although dialysis improves many complications of CKD, the disease does not reverse completely. These patients present an increase in oxidative stress, chronic inflammation and the release of extracellular vesicles (EVs), which cause endothelial damage and the development of different cardiovascular diseases (CVD). CKD patients develop premature diseases associated with advanced age, such as CVD. EVs play an essential role in developing CVD in patients with CKD since their number increases in plasma and their content is modified. The EVs of patients with CKD cause endothelial dysfunction, senescence and vascular calcification. In addition, miRNAs free or transported in EVs together with other components carried in these EVs promote endothelial dysfunction, thrombotic and vascular calcification in CKD, among other effects. This review describes the classic factors and focuses on the role of new mechanisms involved in the development of CVD associated with CKD, emphasizing the role of EVs in the development of cardiovascular pathologies in the context of CKD. Moreover, the review summarized the EVs' role as diagnostic and therapeutic tools, acting on EV release or content to avoid the development of CVD in CKD patients.
慢性肾脏病（CKD）是一种具有高全球发病率和上升趋势的疾病，影响老年人。当 CKD 非常严重时，需要使用肾脏替代疗法来延长其生命（透析或肾移植）。尽管透析改善了 CKD 的许多并发症，但该疾病并不能完全逆转。这些患者表现出氧化应激、慢性炎症和细胞外囊泡（EVs）的释放增加，导致内皮损伤和不同心血管疾病（CVD）的发展。CKD 患者会出现与年龄相关的过早疾病，如 CVD。EVs 在 CKD 患者 CVD 的发展中起着至关重要的作用，因为它们在血浆中的数量增加，其内容物也发生了改变。CKD 患者的 EVs 导致内皮功能障碍、衰老和血管钙化。此外，miRNA 自由或在 EVs 中运输，以及这些 EVs 中携带的其他成分，共同促进了 CKD 中内皮功能障碍、血栓形成和血管钙化等作用。这篇综述描述了经典因素，并重点介绍了与 CKD 相关 CVD 发展中涉及的新机制的作用，强调了 EVs 在 CKD 背景下心血管病理发展中的作用。此外，该综述总结了 EVs 作为诊断和治疗工具的作用，通过作用于 EV 的释放或内容来避免 CKD 患者 CVD 的发展。
