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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.
Keywords
CHRONIC KIDNEY-DISEASE, STAGE RENAL-DISEASE, OBSTRUCTIVE SLEEP-APNEA, LEFT-VENTRICULAR HYPERTROPHY, SYMPATHETIC-NERVOUS-SYSTEM, TRIMETHYLAMINE-N-OXIDE, SMOOTH-MUSCLE-CELLS, PULMONARY NEUROENDOCRINE CELLS, FIBROBLAST GROWTH FACTOR-23, GLOMERULAR-FILTRATION-RATE

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Citation

Please use this url to cite or link to this publication:

MLA
Zoccali, Carmine et al. “The Systemic Nature of CKD.” NATURE REVIEWS NEPHROLOGY 13.6 (2017): n. pag. Print.
APA
Zoccali, C., Vanholder, R., Massy, Z. A., Ortiz, A., Sarafidis, P., Dekker, F. W., Fliser, D., et al. (2017). The systemic nature of CKD. NATURE REVIEWS NEPHROLOGY, 13(6).
Chicago author-date
Zoccali, Carmine, Raymond Vanholder, Ziad A Massy, Alberto Ortiz, Pantelis Sarafidis, Friedo W Dekker, Danilo Fliser, et al. 2017. “The Systemic Nature of CKD.” Nature Reviews Nephrology 13 (6).
Chicago author-date (all authors)
Zoccali, Carmine, 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, and Gerard London. 2017. “The Systemic Nature of CKD.” Nature Reviews Nephrology 13 (6).
Vancouver
1.
Zoccali C, Vanholder R, Massy ZA, Ortiz A, Sarafidis P, Dekker FW, et al. The systemic nature of CKD. NATURE REVIEWS NEPHROLOGY. 2017;13(6).
IEEE
[1]
C. Zoccali et al., “The systemic nature of CKD,” NATURE REVIEWS NEPHROLOGY, vol. 13, no. 6, 2017.
@article{8529580,
  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.},
  author       = {Zoccali, Carmine and Vanholder, Raymond and Massy, Ziad A and Ortiz, Alberto and Sarafidis, Pantelis and Dekker, Friedo W and Fliser, Danilo and Fouque, Denis and Heine, Gunnar H and Jager, Kitty J and Kanbay, Mehmet and Mallamaci, Francesca and Parati, Gianfranco and Rossignol, Patrick and Wiecek, Andrzej and London, Gerard},
  issn         = {1759-5061},
  journal      = {NATURE REVIEWS NEPHROLOGY},
  keywords     = {CHRONIC KIDNEY-DISEASE,STAGE RENAL-DISEASE,OBSTRUCTIVE SLEEP-APNEA,LEFT-VENTRICULAR HYPERTROPHY,SYMPATHETIC-NERVOUS-SYSTEM,TRIMETHYLAMINE-N-OXIDE,SMOOTH-MUSCLE-CELLS,PULMONARY NEUROENDOCRINE CELLS,FIBROBLAST GROWTH FACTOR-23,GLOMERULAR-FILTRATION-RATE},
  language     = {eng},
  number       = {6},
  pages        = {15},
  title        = {The systemic nature of CKD},
  url          = {http://dx.doi.org/10.1038/nrneph.2017.52},
  volume       = {13},
  year         = {2017},
}

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