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2018 ; 11
(3
): 295-301
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Capillary rarefaction from the kidney point of view
#MMPMID29988260
Afsar B
; Afsar RE
; Dagel T
; Kaya E
; Erus S
; Ortiz A
; Covic A
; Kanbay M
Clin Kidney J
2018[Jun]; 11
(3
): 295-301
PMID29988260
show ga
Capillary rarefaction is broadly defined as a reduction in vascular density.
Capillary rarefaction in the kidneys is thought to promote hypoxia, impair
hemodynamic responses and predispose to chronic kidney disease (CKD) progression
and hypertension development. Various mechanisms have been suggested to play a
role in the development of capillary rarefaction, including inflammation, an
altered endothelial-tubular epithelial cell crosstalk, a relative deficiency in
angiogenic growth factors, loss of pericytes, increased activity of Transforming
growth factor -?1 and thrombospondin-1, vitamin D deficiency, a link to lymphatic
neoangiogenesis and INK4a/ARF (Cylin-dependent kinase inhibitor 2a; CDKN2A). In
this review, we summarize the tools available to monitor capillary rarefaction
noninvasively in the clinic, the contribution of capillary rarefaction to CKD and
hypertension, the known mechanisms of capillary rarefaction, and potential future
strategies to attenuate capillary rarefaction and reduce its negative impact.
Therapeutic strategies to be explored in more detail include optimization of
antihypertensive therapy, vitamin D receptor activators, sirtuin 1 activators,
Hypoxia inducible factor prolyl hydroxylase inhibitors and stem cell therapy.