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Review
. 2023 Oct 18;11(10):2828.
doi: 10.3390/biomedicines11102828.

Novel Approaches in Chronic Renal Failure without Renal Replacement Therapy: A Review

Sandra Luz Martínez-Hernández  1 , Martín Humberto Muñoz-Ortega  2 , Manuel Enrique Ávila-Blanco  3 , Mariana Yazmin Medina-Pizaño  3 , Javier Ventura-Juárez  3
Affiliations
Review

Novel Approaches in Chronic Renal Failure without Renal Replacement Therapy: A Review

Sandra Luz Martínez-Hernández et al. Biomedicines. .

Abstract

Chronic kidney disease (CKD) is characterized by renal parenchymal damage leading to a reduction in the glomerular filtration rate. The inflammatory response plays a pivotal role in the tissue damage contributing to renal failure. Current therapeutic options encompass dietary control, mineral salt regulation, and management of blood pressure, blood glucose, and fatty acid levels. However, they do not effectively halt the progression of renal damage. This review critically examines novel therapeutic avenues aimed at ameliorating inflammation, mitigating extracellular matrix accumulation, and fostering renal tissue regeneration in the context of CKD. Understanding the mechanisms sustaining a proinflammatory and profibrotic state may offer the potential for _targeted pharmacological interventions. This, in turn, could pave the way for combination therapies capable of reversing renal damage in CKD. The non-replacement phase of CKD currently faces a dearth of efficacious therapeutic options. Future directions encompass exploring vaptans as diuretics to inhibit water absorption, investigating antifibrotic agents, antioxidants, and exploring regenerative treatment modalities, such as stem cell therapy and novel probiotics. Moreover, this review identifies pharmaceutical agents capable of mitigating renal parenchymal damage attributed to CKD, _targeting molecular-level signaling pathways (TGF-β, Smad, and Nrf2) that predominate in the inflammatory processes of renal fibrogenic cells.

Keywords: anti-fibrotic drugs; chronic kidney disease; metabolism-regulating drugs; new diuretics drugs; novel anti-hypertensives drugs.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Graphical abstract: chronic kidney disease development and treatment; factors influencing renal injury, inflammation, extracellular matrix accumulation, fibrosis, and loss of function; commonly used drugs and novel proposals (figure created in BioRender.com accessed on 4 November 2022).
See this image and copyright information in PMC

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