Accelerated vascular aging in chronic kidney disease: the potential for novel therapies

Hobson, S., Arefin, S., Witasp, A., Hernandez, L., Kublickiene, K., Shiels, P.G. and Stenvinkel, P. (2023) Accelerated vascular aging in chronic kidney disease: the potential for novel therapies. Circulation Research, 132(8), pp. 950-969. (doi: 10.1161/CIRCRESAHA.122.321751) (PMID:37053277)

Abstract

The pathophysiology of vascular disease is linked to accelerated biological aging and a combination of genetic, lifestyle, biological, and environmental risk factors. Within the scenario of uncontrolled artery wall aging processes, CKD (chronic kidney disease) stands out as a valid model for detailed structural, functional, and molecular studies of this process. The cardiorenal syndrome relates to the detrimental bidirectional interplay between the kidney and the cardiovascular system. In addition to established risk factors, this group of patients is subjected to a plethora of other emerging vascular risk factors, such as inflammation, oxidative stress, mitochondrial dysfunction, vitamin K deficiency, cellular senescence, somatic mutations, epigenetic modifications, and increased apoptosis. A better understanding of the molecular mechanisms through which the uremic milieu triggers and maintains early vascular aging processes, has provided important new clues on inflammatory pathways and emerging risk factors alike, and to the altered behavior of cells in the arterial wall. Advances in the understanding of the biology of uremic early vascular aging opens avenues to novel pharmacological and nutritional therapeutic interventions. Such strategies hold promise to improve future prevention and treatment of early vascular aging not only in CKD but also in the elderly general population.

• Item Type: Articles
• Additional Information: The work was supported by the Hjärt-lungfonden (P. Stenvinkel), CIMED (P. Stenvinkel and A. Witasp), Swedish Research Council (2018-00932 [K. Kublickiene] and 2021-01102 [P. Stenvinkel]), Stiftelsen Stig och Gunborg Westman (A. Witasp and P. Stenvinkel), Njurfonden (P. Stenvinkel, K. Kublickiene, S. Arefin) and EU Innovative Training Network CaReSyAn (H2020-MSCA-ITN-764474; P. Stenvinkel and S. Hobson).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Shiels, Professor Paul
• Authors: Hobson, S., Arefin, S., Witasp, A., Hernandez, L., Kublickiene, K., Shiels, P.G., and Stenvinkel, P.
• College/School: College of Medical Veterinary and Life Sciences > School of Molecular Biosciences
• Journal Name: Circulation Research
• Publisher: American Heart Association
• ISSN: 0009-7330
• ISSN (Online): 1524-4571
• Published Online: 13 April 2023
• Copyright Holders: Copyright © 2023 American Heart Association, Inc.
• First Published: First published in Circulation Research 132(8):950-969
• Publisher Policy: Reproduced in accordance with the publisher copyright policy