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Schlitt A, Sester U, Sester M, Seiler-Mussler S, Brandenburg V, Schäffner E, Heine GH. Letter to the Editor regarding Dounousi E et al. Intact FGF23 and α-Klotho during acute inflammation/sepsis in CKD patients. Eur J Clin Invest 2017; 47:468-469. [PMID: 28415155 DOI: 10.1111/eci.12761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 04/11/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Axel Schlitt
- Paracelsus-Harz-Clinic Bad Suderode and Medical Faculty, Martin Luther-University Halle-Wittenberg, Halle, Germany
| | - Urban Sester
- Internal Medicine IV - Nephrology and Hypertension, Saarland University Faculty of Medicine, Saarland University Medical Center, Homburg, Germany
| | - Martina Sester
- Department of Transplant and Infection Immunology, Saarland University, Homburg, Germany
| | - Sarah Seiler-Mussler
- Internal Medicine IV - Nephrology and Hypertension, Saarland University Faculty of Medicine, Saarland University Medical Center, Homburg, Germany
| | - Vincent Brandenburg
- Department of Cardiology, University Hospital of the RWTH Aachen, Aachen, Germany
| | - Elke Schäffner
- Institute of Public Health, Charité University Medicine, Berlin, Germany
| | - Gunnar H Heine
- Internal Medicine IV - Nephrology and Hypertension, Saarland University Faculty of Medicine, Saarland University Medical Center, Homburg, Germany
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Dounousi E, Torino C, Pizzini P, Cutrupi S, Panuccio V, D'Arrigo G, Abd ElHafeez S, Tripepi G, Mallamaci F, Zoccali C. Intact FGF23 and α-klotho during acute inflammation/sepsis in CKD patients. Eur J Clin Invest 2017; 47:470-472. [PMID: 28489248 DOI: 10.1111/eci.12765] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 04/22/2017] [Indexed: 02/01/2023]
Affiliation(s)
| | - Claudia Torino
- Clinical Epidemiology and Physiopathology of Renal Disease and Hypertension, CNR-IFC, Reggio Calabria, Italy
| | - Patrizia Pizzini
- Clinical Epidemiology and Physiopathology of Renal Disease and Hypertension, CNR-IFC, Reggio Calabria, Italy
| | - Sebastiano Cutrupi
- Clinical Epidemiology and Physiopathology of Renal Disease and Hypertension, CNR-IFC, Reggio Calabria, Italy
| | - Vincenzo Panuccio
- Division of Nephrology, Dialysis and Transplantation, OORR Reggio Calabria, Reggio Calabria, Italy
| | - Graziella D'Arrigo
- Clinical Epidemiology and Physiopathology of Renal Disease and Hypertension, CNR-IFC, Reggio Calabria, Italy
| | | | - Giovanni Tripepi
- Clinical Epidemiology and Physiopathology of Renal Disease and Hypertension, CNR-IFC, Reggio Calabria, Italy
| | - Francesca Mallamaci
- Clinical Epidemiology and Physiopathology of Renal Disease and Hypertension, CNR-IFC, Reggio Calabria, Italy.,Division of Nephrology, Dialysis and Transplantation, OORR Reggio Calabria, Reggio Calabria, Italy
| | - Carmine Zoccali
- Clinical Epidemiology and Physiopathology of Renal Disease and Hypertension, CNR-IFC, Reggio Calabria, Italy
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3
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Zoccali C, Vanholder R, Massy ZA, Ortiz A, Sarafidis P, Dekker FW, Fliser D, Fouque D, Heine GH, Jager KJ, Kanbay M, Mallamaci F, Parati G, Rossignol P, Wiecek A, London G. The systemic nature of CKD. Nat Rev Nephrol 2017; 13:344-358. [PMID: 28435157 DOI: 10.1038/nrneph.2017.52] [Citation(s) in RCA: 229] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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.
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Affiliation(s)
- Carmine Zoccali
- CNR-IFC Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension Unit, Ospedali Riuniti 89124 Reggio Calabria, Italy
| | - Raymond Vanholder
- Ghent University Hospital, Department of Nephrology, Department of Internal Medicine, University Hospital Gent, De Pintelaan 185, B9000 Ghent, Belgium
| | - Ziad A Massy
- Division of Nephrology, Ambroise Paré Hospital, Assistance Publique Hôpitaux de Paris, 9 Avenue Charles de Gaulle, 92100 Boulogne-Billancourt, Paris.,University of Paris Ouest-Versailles-Saint-Quentin-en-Yvelines (UVSQ), 55 Avenue de Paris, 78000 Versailles, France.,Inserm U-1018, Centre de recherche en épidémiologie et santé des populations (CESP), Equipe 5, Hôpital Paul-Brousse, 16 avenue Paul Vaillant-Couturier, 94807 Villejuif Cedex, France.,Paris-Sud University (PSU), 15 Rue Georges Clemenceau, 91400 Orsay, France.,French-Clinical Research Infrastructure Network (F-CRIN), Pavillon Leriche 2è étage CHU de Toulouse, Place Dr Baylac TSA40031, 31059 TOULOUSE Cedex 3, France
| | - Alberto Ortiz
- Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Fundación Renal Iñigo Alvarez de Toledo, Madrid, Av. Reyes Católicos, 2, 28040 Madrid, Spain
| | - Pantelis Sarafidis
- Department of Nephrology, Hippokration Hospital, Thessaloniki, Konstantinoupoleos 49, Thessaloniki 546 42, Greece
| | - Friedo W Dekker
- Department of Clinical Epidemiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Danilo Fliser
- Department Internal Medicine IV-Renal and Hypertensive Disease-Saarland University Medical Centre Kirrberger Straß 66421 Homburg, Saar, Germany
| | - Denis Fouque
- Université de Lyon, UCBL, Carmen, Department of Nephrology, Centre Hospitalier Lyon-Sud, F-69495 Pierre Bénite, France
| | - Gunnar H Heine
- Department Internal Medicine IV-Renal and Hypertensive Disease-Saarland University Medical Centre Kirrberger Straß 66421 Homburg, Saar, Germany
| | - Kitty J Jager
- European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry, Department of Medical Informatics, Meibergdreef 9, 1105 AZ Amsterdam-Zuidoost, The Netherlands
| | - Mehmet Kanbay
- Division of Nephrology, Department of Medicine,Koç University, Rumelifeneri Yolu 34450 Sarıyer Istanbul, Turkey
| | - Francesca Mallamaci
- CNR-IFC Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension Unit, Ospedali Riuniti 89124 Reggio Calabria, Italy.,Nephrology, Dialysis and Transplantation Unit Ospedali Riuniti, 89124 Reggio Calabria Italy
| | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, S. Luca Hospital, Istituto Auxologico Italiano &Department of Medicine and Surgery, University of Milan-Bicocca, Piazzale Brescia 20, Milan 20149, Italy
| | - Patrick Rossignol
- French-Clinical Research Infrastructure Network (F-CRIN), Pavillon Leriche 2è étage CHU de Toulouse, Place Dr Baylac TSA40031, 31059 TOULOUSE Cedex 3, France.,Inserm, Centre d'Investigations Cliniques-Plurithématique 1433, Cardiovascular and Renal Clinical Trialists (INI-CRCT), Institut Lorrain du Cœur et des Vaisseaux Louis Mathieu, 4 rue Morvan, 54500 Vandoeuvre-les-Nancy, France.,Inserm U1116, Faculté de Médecine, Bâtiment D 1er étage, 9 avenue de la forêt de Haye - BP 184, 54500 Vandœuvre-lès-Nancy Cedex, France.,CHU Nancy, Département de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, 5 Rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.,Université de Lorraine, 34 Cours Léopold, 54000 Nancy, France
| | - Andrzej Wiecek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20/24 Street, Pl-40-027 Katowice, Poland
| | - Gerard London
- INSERM U970, Hopital Européen Georges Pompidou, 20 Rue Leblanc, 75015 Paris, France
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