Innovative Treatments to Counteract Endothelial Dysfunction in Chronic Kidney Disease Patients.

作者信息

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

机构信息

Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.

Nephrology and Dialysis Unit, Department of Systems Medicine, University Hospital of Rome Tor Vergata, 00133 Rome, Italy.

出版信息

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

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.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/196f/11117580/e93b6cbe566a/biomedicines-12-01085-g001.jpg

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