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2015 ; 6
(ä): 340
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Cellular and Molecular Mechanisms of Chronic Kidney Disease with Diabetes
Mellitus and Cardiovascular Diseases as Its Comorbidities
#MMPMID26217336
Gajjala PR
; Sanati M
; Jankowski J
Front Immunol
2015[]; 6
(ä): 340
PMID26217336
show ga
Chronic kidney disease (CKD), diabetes mellitus (DM), and cardiovascular diseases
(CVD) are complex disorders of partly unknown genesis and mostly known
progression factors. CVD and DM are the risk factors of CKD and are strongly
intertwined since DM can lead to both CKD and/or CVD, and CVD can lead to kidney
disease. In recent years, our knowledge of CKD, DM, and CVD has been expanded and
several important experimental, clinical, and epidemiological associations have
been reported. The tight cellular and molecular interactions between the renal,
diabetic, and cardiovascular systems in acute or chronic disease settings are
becoming increasingly evident. However, the (patho-) physiological basis of the
interactions of CKD, DM, and CVD with involvement of multiple endogenous and
environmental factors is highly complex and our knowledge is still at its
infancy. Not only single pathways and mediators of progression of these diseases
have to be considered in these processes but also the mutual interactions of
these factors are essential. The recent advances in proteomics and integrative
analysis technologies have allowed rapid progress in analyzing complex disorders
and clearly show the opportunity for new efficient and specific therapies. More
than a dozen pathways have been identified so far, including hyperactivity of the
renin-angiotensin (RAS)-aldosterone system, osmotic sodium retention, endothelial
dysfunction, dyslipidemia, RAS/RAF/extracellular-signal-regulated kinase pathway,
modification of the purinergic system, phosphatidylinositol 3-kinase (PI
3-kinase)-dependent signaling pathways, and inflammation, all leading to
histomorphological alterations of the kidney and vessels of diabetic and
non-diabetic patients. Since a better understanding of the common cellular and
molecular mechanisms of these diseases may be a key to successful identification
of new therapeutic targets, we review in this paper the current literature about
cellular and molecular mechanisms of CKD.