THE ROLE OF KIDNEYS ENDOTHELIAL DYSFUNCTION IN THE PATHOGENESIS OF DISEASES AND THEIR COMPLICATIONS
(REVIEW OF LITERATURE)
DOI:
https://doi.org/10.11603/1811-2471.2019.v.i3.10503Keywords:
endothelial dysfunction, kidneys, diabetes mellitus, autoimmune diseases, kidney cancerAbstract
Summary. Endothelial dysfunction is one of the early and important components of the pathogenesis of many serious diseases, such as diabetes mellitus, atherosclerosis, systemic autoimmune rheumatic diseases, oncopathology, and the like. A significant role in these processes plays in the functional state of the renal endothelium, as about 30 % of the endothelial plate of the vessels of the body is in the kidneys. The purpose of this study was to search, systematize and analyze existing scientific publications about the role of systemic endothelial dysfunction in general and disorders of the renal endothelium, in particular in the mechanisms of development of various diseases, as well as their complications. Endothelial dysfunction recognized as one of the main factors in the pathogenesis of atherosclerosis and its complications, heart failure, diabetic angiopathy, and the like. Damage to the renal endothelium violates normal regulatory relationships, an imbalance of active vascular mediators arises, the antithrombogenic activity of the vascular wall changes.
Under the influence of long-term hyperglycemia, cells of the endothelium begin to produce factors that accelerate the processes of atherogenesis: ET-1, the expression of adhesion molecules activated, aggregation of platelets, and proliferation of smooth muscle cells enhanced. Endothelial dysfunction with systemic autoimmune rheumatic diseases is accompanied by overproduction of vascular endothelial growth factor (VEGF), endothelin-1, E-selectin (ESel) and, as a consequence, damage to the capillaries of glomeruli and arterioles in the kidneys. VEGF acts as a key tumor angiogenesis mediator, stimulating the growth of new blood vessels from the nearest capillaries, thereby giving tumor access to oxygen and nutrients; also plays an important role in maintaining the vascular mesh of the tumor, preventing the apoptosis of immature endothelial cells. The evaluation of endothelial dysfunction in the mechanisms of disease development should be comprehensive and systematic, based on the study of endothelial dysfunction, the study of markers of its damage, and the development of appropriate modern treatments.
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