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This review summarises the molecular regulatory mechanisms underlying endothelial dysfunction in CKD and highlights recent advances in treatment strategies. The pathophysiology of endothelial injuries involves a complex network of multiple factors and mechanisms, including oxidative stress, inflammation, glycocalyx damage, ischaemia, hypoxia, cellular senescence and endothelial\u2010mesenchymal transition (EndMT). Recent advances have yielded several promising CKD treatment strategies, including dual endothelin\u2010angiotensin receptor antagonists (DEARA), dipeptidyl peptidase\u20104 inhibitors (DPP\u20104i), glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101RA), renin\u2010angiotensin\u2010aldosterone system inhibitors (RAASi), sodium\u2010glucose cotransporter 2 inhibitors (SGLT2i) and mineralocorticoid receptor antagonists (MRA), which have demonstrated favourable protective effects on endothelial cells. Moreover, emerging anti\u2010ageing therapies are novel therapeutic directions for research related to endothelial protection. In future studies, the synergistic effects of nonpharmacological interventions (such as lifestyle modifications and nutritional support) and pharmacological therapies will be a new direction, providing ideas for improving endothelial dysfunction, decelerating the progression of CKD, reducing the risk of cardiovascular events, and ultimately improving patient outcomes.<\/jats:p>","DOI":"10.1002\/dmrr.70086","type":"journal-article","created":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T18:59:09Z","timestamp":1757271549000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Endothelial Dysfunction and Therapeutic Advances in Chronic Kidney Disease"],"prefix":"10.1002","volume":"41","author":[{"given":"Feng","family":"Liang","sequence":"first","affiliation":[{"name":"Department of Nephrology Daping Hospital Army Medical University  Chongqing China"},{"name":"The Key Laboratory of Precision Diagnosis and Treatment 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