Abstract
Chronic kidney disease can progress to end-stage chronic renal disease (ESRD), which requires the use of replacement therapy (dialysis or kidney transplant) in life-threatening conditions. In ESRD, irreversible changes in the kidneys are associated with systemic changes of proinflammatory nature and dysfunctions of internal organs, skeletal muscles, and integumentary tissues. The common components of ESRD pathogenesis, regardless of the initial nosology, are (1) local (in the kidneys) and systemic chronic low-grade inflammation (ChLGI) as a risk factor for diabetic kidney disease and its progression to ESRD, (2) inflammation of the classical type characteristic of primary and secondary autoimmune glomerulonephritis and infectious recurrent pyelonephritis, as well as immune reactions in kidney allograft rejection, and (3) chronic systemic inflammation (ChSI), pathogenetically characterized by latent microcirculatory disorders and manifestations of paracoagulation. The development of ChSI is closely associated with programmed hemodialysis in ESRD, as well as with the systemic autoimmune process. Consideration of ESRD pathogenesis from the standpoint of the theory of general pathological processes opens up the scope not only for particular but also for universal approaches to conducting pathogenetic therapies and diagnosing and predicting systemic complications in severe nephropathies.
Highlights
In two individuals with systemic lupus erythematosus, we found an reactivity level (RL)-5 level of systemic inflammatory response (SIR) that was uncommon for chronic disease
These approaches must take into account the fundamental laws, as well as the separation of the specific and the general, where the role of the general is played by general pathological processes
The most fundamental general pathological processes associated with the molecular mechanisms of inflammation are
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. It is often unclear which processes these identified molecular mechanisms relate to This concerns both the accumulation of inflammatory mediators in the blood and the presence of other signs of a systemic inflammatory response (SIR). That is why “inflammation” requires classification into several independent common pathological processes to determine their common and different molecular and cellular mechanisms From these vantage points, a large group of diseases is a convenient material for describing the role of key general pathological processes associated with inflammation. We think this article could be interesting for nephrologists and specialists in related clinical disciplines, as well as pathological physiologists, general pathologists, immunologists, and other fundamental medicine and molecular biology representatives With this in mind, we outline the causes and consequences of end-stage renal disease (ESRD). This review reveals the general and distinctive molecular and cellular mechanisms of various general pathological processes of inflammation, as well as their interconnections during the development of severe renal pathology
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