The systemic nature of CKD

Carmine Zoccali, Raymond Vanholder, Ziad A. Massy, Alberto Ortiz, Pantelis Sarafidis, Friedo W. Dekker, Danilo Fliser, Denis Fouque, Gunnar H. Heine, Kitty J. Jager, Mehmet Kanbay, Francesca Mallamaci, Gianfranco Parati, Patrick Rossignol, Andrzej Wiecek, Gerard London

Research output: Contribution to journalReview article

Abstract

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.

Original languageEnglish
Pages (from-to)344-358
Number of pages15
JournalNature Reviews Nephrology
Volume13
Issue number6
DOIs
Publication statusPublished - Jun 1 2017

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Chronic Renal Insufficiency
Kidney
Autonomic Nervous System Diseases
Biological Phenomena
Critical Pathways
Systems Biology
Nephrology
Bone Diseases
Kidney Diseases
Vascular Diseases
Innate Immunity
Inflammation
Phenotype
Bone and Bones
Research
Proteins
Therapeutics

ASJC Scopus subject areas

  • Nephrology

Cite this

Zoccali, C., Vanholder, R., Massy, Z. A., Ortiz, A., Sarafidis, P., Dekker, F. W., ... London, G. (2017). The systemic nature of CKD. Nature Reviews Nephrology, 13(6), 344-358. https://doi.org/10.1038/nrneph.2017.52

The systemic nature of CKD. / Zoccali, Carmine; Vanholder, Raymond; Massy, Ziad A.; Ortiz, Alberto; Sarafidis, Pantelis; Dekker, Friedo W.; Fliser, Danilo; Fouque, Denis; Heine, Gunnar H.; Jager, Kitty J.; Kanbay, Mehmet; Mallamaci, Francesca; Parati, Gianfranco; Rossignol, Patrick; Wiecek, Andrzej; London, Gerard.

In: Nature Reviews Nephrology, Vol. 13, No. 6, 01.06.2017, p. 344-358.

Research output: Contribution to journalReview article

Zoccali, C, Vanholder, R, Massy, ZA, Ortiz, A, Sarafidis, P, Dekker, FW, Fliser, D, Fouque, D, Heine, GH, Jager, KJ, Kanbay, M, Mallamaci, F, Parati, G, Rossignol, P, Wiecek, A & London, G 2017, 'The systemic nature of CKD', Nature Reviews Nephrology, vol. 13, no. 6, pp. 344-358. https://doi.org/10.1038/nrneph.2017.52
Zoccali C, Vanholder R, Massy ZA, Ortiz A, Sarafidis P, Dekker FW et al. The systemic nature of CKD. Nature Reviews Nephrology. 2017 Jun 1;13(6):344-358. https://doi.org/10.1038/nrneph.2017.52
Zoccali, Carmine ; Vanholder, Raymond ; Massy, Ziad A. ; Ortiz, Alberto ; Sarafidis, Pantelis ; Dekker, Friedo W. ; Fliser, Danilo ; Fouque, Denis ; Heine, Gunnar H. ; Jager, Kitty J. ; Kanbay, Mehmet ; Mallamaci, Francesca ; Parati, Gianfranco ; Rossignol, Patrick ; Wiecek, Andrzej ; London, Gerard. / The systemic nature of CKD. In: Nature Reviews Nephrology. 2017 ; Vol. 13, No. 6. pp. 344-358.
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