Peritubular endothelium: The Achilles heel of the kidney?

• Published in: Kidney international Vol. 72; no. 8; pp. 926 - 930
• Main Authors: Rabelink, T.J., Wijewickrama, D.C., de Koning, E.J.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2007; Nature Publishing; Elsevier Limited
• Subjects: Animals; Biological and medical sciences; Capillaries - pathology; Capillaries - physiopathology; Disease Progression; end-stage renal disease; endothelium; Endothelium, Vascular - pathology; Endothelium, Vascular - physiopathology; Humans; Ischemia - complications; Ischemia - pathology; Ischemia - physiopathology; Kidney Diseases - etiology; Kidney Diseases - pathology; Kidney Diseases - physiopathology; Kidney Medulla - blood supply; Kidney Tubules - blood supply; Medical sciences; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Renal failure; tubular epithelium; vascular; endothelium; tubular epithelium; end-stage renal disease; vascular; Kidney disease; Nephrology; Urinary system disease; Terminal stage; Epithelium; Urology; Endothelium; Renal tubule; Urinary system; Blood vessel; Renal failure; Circulatory system
• ISSN: 0085-2538; 1523-1755
• DOI: 10.1038/sj.ki.5002414

The development of renal ischemia has been postulated to be a main cause of the progressive nature of kidney diseases. In recent years, it has become clear that inappropriate and sustained activation of the endothelium could mediate this phenomenon. Endothelial activation will result in leucostasis and can compromise peritubular flow. The associated sustained redox signaling will also accelerate the development of endothelial senescence. In addition, risk factors for renal disease progression can reduce endothelial repair. In the course of these events, loss of capillary structure and rarefaction develops, which drives the further development of nephron loss. In this mini review, the evidence for this pathophysiological concept as well as the possibility to detect such endothelial activation in the clinical arena is summarized.