title: Blood pressure, proteinuria, and phosphate as risk factors for progressive kidney disease: a hypothesis.
abstract: Chronic kidney disease (CKD) affects approximately 500 million people worldwide and is increasingly common in both industrialized and emerging countries. Although the mechanisms underlying the inexorable progression of CKD are incompletely defined, recent discoveries may pave the way to a more comprehensive understanding of the pathophysiology of CKD progression and the development of new therapeutic strategies. In particular, there is accumulating evidence indicating a key role for the complex and yet incompletely understood system of divalent cation regulation, which includes phosphate metabolism and the recently discovered fibroblast growth factor 23 (FGF-23)/klotho system, which seems inextricably associated with vitamin D deficiency. The aim of this review is to discuss the links between high blood pressure, proteinuria, phosphate levels, and CKD progression and explore new therapeutic strategies to win the fight against CKD.
authors.affiliation: Department of Health Sciences, University of Milan, Renal Division, San Paolo Hospital, Milan, Italy. Electronic address: mario.cozzolino@unimi.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Cozzolino
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gentile
authors.forename: Sandro
authors.initials: S
authors.lastname: Mazzaferro
authors.forename: Diego
authors.initials: D
authors.lastname: Brancaccio
authors.forename: Piero
authors.initials: P
authors.lastname: Ruggenenti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Remuzzi
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D018450:Disease Progression; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000502:physiology; D005966:Glucuronidase / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D007674:Kidney Diseases / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology; D000090265:Klotho Proteins; D010758:Phosphorus / Q000378:metabolism*; D011507:Proteinuria / Q000150:complications* / Q000503:physiopathology; D012307:Risk Factors; D014808:Vitamin D Deficiency / Q000150:complications / Q000503:physiopathology
chemical_list: C000717427:FGF23 protein, human; D010758:Phosphorus; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D005966:Glucuronidase; D000090265:Klotho Proteins
keywords: Chronic kidney disease; blood pressure; phosphate; proteinuria; vitamin D deficiency