Журнал нефрологии и терапии

The renal tubules play a crucial role in the intricate functioning of the kidneys, facilitating the reabsorption of essential substances and the excretion of waste products. Tubular diseases, characterized by the dysfunction of these vital structures, can have profound implications for overall kidney health. This article delves into the pathogenesis of tubular diseases, exploring the underlying mechanisms and highlighting emerging therapeutic strategies that hold promise in managing these conditions. Before delving into the complexities of tubular diseases, it is essential to understand the anatomy and physiology of renal tubules. The nephron, the functional unit of the kidney, consists of the renal corpuscle and renal tubule.

Diabetic Nephropathy (DN) is a serious and common complication of diabetes mellitus, affecting a significant number of individuals worldwide. It is a progressive kidney disease that develops in patients with diabetes, ultimately leading to renal failure if left untreated. Understanding the molecular mechanisms underlying diabetic nephropathy is crucial for developing effective therapeutic strategies to manage and prevent its progression. This article explores the intricate molecular pathways involved in the development and progression of diabetic nephropathy.

Renal Replacement Therapy plays a crucial role in the management of end-stage renal disease, a condition characterized by the irreversible loss of kidney function. As the prevalence of ESRD continues to rise globally, the demand for effective and efficient renal replacement therapies is more pressing than ever. In recent years, technological advancements have revolutionized the landscape of kidney care, offering new possibilities for improving the outcomes and quality of life for patients undergoing RRT. This article explores the significant role that technology plays in transforming renal replacement therapy and its impact on the field of kidney care.

Chronic Kidney Disease (CKD) is a worldwide public health problem associated with high morbidity, mortality, and socioeconomic burden. Despite recent advances in pathogenesis and effective Standard of Care (SOC) therapy, the incidence of end stage renal disease remains high, attributed to the complex and diverse pathophysiological pathways in progression of CKD. Among the many pathogenetic pathways, inflammation plays the most central role in disease progression and related complications. Current SOC treatment to slow CKD progression has not adequately addressed these complex processes as a result of persistence of low-grade inflammation occurring at all stages of CKD. Previous attempts to address the inflammatory pathway with specific anti-inflammatory agents were, in certain cases discontinued for reasons ranging from drug safety to efficacy concerns, and business development decisions. Recent research findings demonstrating direct correlation between systemic inflammation associated gut microbiota changes and CKD progression, provided a potential novel therapeutic approach to target the inflammatory pathways. Exploring current scientific knowledge of modulating gut microbiome with microbiome-based therapies provides options in addressing these complex pathogenetic mechanisms of CKD-induced inflammation.

The purpose of this minireview is to discuss the role of inflammation associated with gut microbiome changes in CKD progression and gut microbiome-based therapeutic options to slow CKD progression.