TY - JOUR
T1 - The systemic nature of CKD
AU - Zoccali, Carmine
AU - Vanholder, Raymond
AU - Massy, Ziad A.
AU - Ortiz, Alberto
AU - Sarafidis, Pantelis
AU - Dekker, Friedo W.
AU - Fliser, Danilo
AU - Fouque, Denis
AU - Heine, Gunnar H.
AU - Jager, Kitty J.
AU - Kanbay, Mehmet
AU - Mallamaci, Francesca
AU - Parati, Gianfranco
AU - Rossignol, Patrick
AU - Wiecek, Andrzej
AU - London, Gerard
PY - 2017
Y1 - 2017
N2 - The accurate definition and staging of chronic kidney disease (CKD) is one of the major achievements of modern nephrology. Intensive research is now being undertaken to unravel the risk factors and pathophysiologic underpinnings of this disease. In particular, the relationships between the kidney and other organs have been comprehensively investigated in experimental and clinical studies in the last two decades. Owing to technological and analytical limitations, these links have been studied with a reductionist approach focusing on two organs at a time, such as the heart and the kidney or the bone and the kidney. Here, we discuss studies that highlight the complex and systemic nature of CKD. Energy balance, innate immunity and neuroendocrine signalling are highly integrated biological phenomena. The diseased kidney disrupts such integration and generates a high-risk phenotype with a clinical profile encompassing inflammation, protein-energy wasting, altered function of the autonomic and central nervous systems and cardiopulmonary, vascular and bone diseases. A systems biology approach to CKD using omics techniques will hopefully enable in-depth study of the pathophysiology of this systemic disease, and has the potential to unravel critical pathways that can be targeted for CKD prevention and therapy
AB - The accurate definition and staging of chronic kidney disease (CKD) is one of the major achievements of modern nephrology. Intensive research is now being undertaken to unravel the risk factors and pathophysiologic underpinnings of this disease. In particular, the relationships between the kidney and other organs have been comprehensively investigated in experimental and clinical studies in the last two decades. Owing to technological and analytical limitations, these links have been studied with a reductionist approach focusing on two organs at a time, such as the heart and the kidney or the bone and the kidney. Here, we discuss studies that highlight the complex and systemic nature of CKD. Energy balance, innate immunity and neuroendocrine signalling are highly integrated biological phenomena. The diseased kidney disrupts such integration and generates a high-risk phenotype with a clinical profile encompassing inflammation, protein-energy wasting, altered function of the autonomic and central nervous systems and cardiopulmonary, vascular and bone diseases. A systems biology approach to CKD using omics techniques will hopefully enable in-depth study of the pathophysiology of this systemic disease, and has the potential to unravel critical pathways that can be targeted for CKD prevention and therapy
U2 - https://doi.org/10.1038/nrneph.2017.52
DO - https://doi.org/10.1038/nrneph.2017.52
M3 - Review article
C2 - 28435157
SN - 1759-5061
VL - 13
SP - 344
EP - 358
JO - Nature reviews. Nephrology
JF - Nature reviews. Nephrology
IS - 6
ER -