Fibrosis in Chronic Kidney Disease: Pathogenesis and Consequences

• Published in: International journal of molecular sciences Vol. 22; no. 1; p. 408
• Main Authors: Panizo, Sara, Martínez-Arias, Laura, Alonso-Montes, Cristina, Cannata, Pablo, Martín-Carro, Beatriz, Fernández-Martín, José L, Naves-Díaz, Manuel, Carrillo-López, Natalia, Cannata-Andía, Jorge B
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 02.01.2021; MDPI
• Subjects: Angiotensin; Apoptosis; Cardiomyocytes; Cardiovascular disease; Connective tissue; Cytokines; Diabetes Mellitus - metabolism; Disease Progression; Extracellular matrix; Female; FGF23; Fibroblast growth factor 23; Fibroblast Growth Factors - metabolism; Fibroblasts; Fibrosis; Fibrosis - metabolism; Fibrosis - pathology; Glucuronidase - metabolism; Growth factors; Humans; Inflammation; Inflammation - metabolism; Kidney diseases; Klotho; Klotho protein; Male; MicroRNAs - genetics; MicroRNAs - metabolism; miRNA; Mortality; Parathyroid; Parathyroid hormone; Parathyroid Hormone - metabolism; Pathogenesis; Phosphates - metabolism; Proteins; PTH; RAS; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - metabolism; Renal Insufficiency, Chronic - pathology; Renin; Renin-Angiotensin System; Review; Tumor necrosis factor-TNF; Vitamin D; Vitamin D - metabolism; Wound healing; microRNAs; PTH; RAS; inflammation; vitamin D; fibrosis; Klotho; FGF23; image analysis; artificial intelligence
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms22010408

Fibrosis is a process characterized by an excessive accumulation of the extracellular matrix as a response to different types of tissue injuries, which leads to organ dysfunction. The process can be initiated by multiple and different stimuli and pathogenic factors which trigger the cascade of reparation converging in molecular signals responsible of initiating and driving fibrosis. Though fibrosis can play a defensive role, in several circumstances at a certain stage, it can progressively become an uncontrolled irreversible and self-maintained process, named pathological fibrosis. Several systems, molecules and responses involved in the pathogenesis of the pathological fibrosis of chronic kidney disease (CKD) will be discussed in this review, putting special attention on inflammation, renin-angiotensin system (RAS), parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), Klotho, microRNAs (miRs), and the vitamin D hormonal system. All of them are key factors of the core and regulatory pathways which drive fibrosis, having a great negative kidney and cardiac impact in CKD.