{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:57:41Z","timestamp":1792799861957,"version":"4.5.0"},"reference-count":114,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Cardiorenal syndrome (CRS) is a multifactorial clinical condition characterized by the bidirectional deterioration of cardiac and renal function, driven by mechanisms such as renin\u2013angiotensin\u2013aldosterone system (RAAS) overactivation, systemic inflammation, oxidative stress, endothelial dysfunction, and fibrosis. The aim of this narrative review is to explore the key molecular pathways involved in CRS and to highlight emerging therapeutic approaches, with a special emphasis on nutritional interventions. We examined recent evidence on the contribution of mitochondrial dysfunction, uremic toxins, and immune activation to CRS progression and assessed the role of dietary and micronutrient factors. Results indicate that a high dietary intake of sodium, phosphorus additives, and processed foods is associated with volume overload, vascular damage, and inflammation, whereas deficiencies in potassium, magnesium, and vitamin D correlate with worse clinical outcomes. Anti-inflammatory and antioxidant bioactives, such as omega-3 PUFAs, curcumin, and anthocyanins from maqui, demonstrate potential to modulate key CRS mechanisms, including the nuclear factor kappa B (NF-\u03baB) pathway and the NLRP3 inflammasome. Gene therapy approaches targeting endothelial nitric oxide synthase (eNOS) and transforming growth factor-beta (TGF-\u03b2) signaling are also discussed. An integrative approach combining pharmacological RAAS modulation with personalized medical nutrition therapy and anti-inflammatory nutrients may offer a promising strategy to prevent or delay CRS progression and improve patient outcomes.<\/jats:p>","DOI":"10.3390\/ijms26157440","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T15:56:16Z","timestamp":1754409376000},"page":"7440","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Cardiorenal Syndrome: Molecular Pathways Linking Cardiovascular Dysfunction and Chronic Kidney Disease Progression"],"prefix":"10.3390","volume":"26","author":[{"given":"Fabian","family":"Vasquez","sequence":"first","affiliation":[{"name":"Escuela de Nutrici\u00f3n y Diet\u00e9tica, Universidad Finis Terrae, Santiago 8320000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Tiscornia","sequence":"additional","affiliation":[{"name":"Escuela de Nutrici\u00f3n y Diet\u00e9tica, Universidad Finis Terrae, Santiago 8320000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1881-2798","authenticated-orcid":false,"given":"Enrique","family":"Lorca-Ponce","sequence":"additional","affiliation":[{"name":"Escuela de Enfermer\u00eda, Universidad Finis Terrae, Santiago 8320000, Chile"},{"name":"Escuela de Kinesiolog\u00eda, Facultad de Arte y Educaci\u00f3n F\u00edsica, Universidad Metropolitana en Ciencias de la Educaci\u00f3n, Santiago 7760170, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Aicardi","sequence":"additional","affiliation":[{"name":"Unidad de Di\u00e1lisis, Cl\u00ednica Indisa, Santiago 7501014, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Vasquez","sequence":"additional","affiliation":[{"name":"Escuela de Medicina, Universidad de Chile, Santiago 8380492, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1016\/j.jacc.2008.07.051","article-title":"Cardiorenal Syndrome","volume":"52","author":"Ronco","year":"2008","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e840","DOI":"10.1161\/CIR.0000000000000664","article-title":"Cardiorenal Syndrome: Classification, Pathophysiology, Diagnosis, and Treatment Strategies: A Scientific Statement from the American Heart Association","volume":"139","author":"Rangaswami","year":"2019","journal-title":"Circulation"},{"key":"ref_3","first-page":"253","article-title":"AS\u00edndrome cardiorrenal: Clasificaci\u00f3n, fisiopatolog\u00eda, diagn\u00f3stico y tratamiento. Una revisi\u00f3n de las publicaciones m\u00e9dicas","volume":"92","year":"2022","journal-title":"Arch. Cardiol. Mex."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1161\/01.RES.0000043825.01705.1B","article-title":"Inflammatory Mediators and the Failing Heart: Past, Present, and the Foreseeable Future","volume":"91","author":"Mann","year":"2002","journal-title":"Circ. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1016\/j.kint.2017.05.034","article-title":"The Hallmarks of Mitochondrial Dysfunction in Chronic Kidney Disease","volume":"92","author":"Galvan","year":"2017","journal-title":"Kidney Int."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1159\/000321845","article-title":"Lipid Disorders and Their Relevance to Outcomes in Chronic Kidney Disease","volume":"31","author":"Vaziri","year":"2011","journal-title":"Blood Purif."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3391","DOI":"10.1093\/ndt\/gfm393","article-title":"Treatment Targets in Renal Fibrosis","volume":"22","author":"Boor","year":"2007","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1093\/eurheartj\/ehr304","article-title":"Nitric Oxide Synthases: Regulation and Function","volume":"33","author":"Sessa","year":"2012","journal-title":"Eur. Heart J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1152\/physrev.00047.2003","article-title":"Role of Oxidative Modifications in Atherosclerosis","volume":"84","author":"Stocker","year":"2004","journal-title":"Physiol. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1080\/10715762.2017.1296575","article-title":"Indoxyl Sulfate Potentiates Endothelial Dysfunction via Reciprocal Role for Reactive Oxygen Species and RhoA\/ROCK Signaling in 5\/6 Nephrectomized Rats","volume":"51","author":"Chu","year":"2017","journal-title":"Free Radic. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"30","DOI":"10.2215\/CJN.05340610","article-title":"Indoxyl Sulfate-Induced Endothelial Dysfunction in Patients with Chronic Kidney Disease via an Induction of Oxidative Stress","volume":"6","author":"Yu","year":"2011","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1159\/000082014","article-title":"C-Reactive Protein in End-Stage Renal Disease: Are There Reasons to Measure It?","volume":"23","author":"Stenvinkel","year":"2005","journal-title":"Blood Purif."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Aranda-Rivera, A.K., Srivastava, A., Cruz-Gregorio, A., Pedraza-Chaverri, J., Mulay, S.R., and Scholze, A. (2022). Involvement of Inflammasome Components in Kidney Disease. Antioxidants, 11.","DOI":"10.3390\/antiox11020246"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1053\/ajkd.2000.16225","article-title":"Preserving Renal Function in Adults with Hypertension and Diabetes: A Consensus Approach","volume":"36","author":"Bakris","year":"2000","journal-title":"Am. J. Kidney Dis."},{"key":"ref_15","first-page":"419","article-title":"Ageing and the Glomerular Filtration Rate: Truths and Consequences","volume":"120","author":"Glassock","year":"2009","journal-title":"Trans. Am. Clin. Climatol. Assoc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1056\/NEJMoa1409077","article-title":"Angiotensin-Neprilysin Inhibition versus Enalapril in Heart Failure","volume":"371","author":"McMurray","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Vanholder, R., Snauwaert, E., Verbeke, F., and Glorieux, G. (2024). Future of Uremic Toxin Management. Toxins, 16.","DOI":"10.3390\/toxins16110463"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jchf.2012.10.002","article-title":"Heart Failure","volume":"1","author":"Braunwald","year":"2013","journal-title":"JACC Heart Fail."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1038\/ncpcardio0012","article-title":"Mechanisms of Disease: Local Renin\u2013Angiotensin\u2013Aldosterone Systems and the Pathogenesis and Treatment of Cardiovascular Disease","volume":"1","author":"Re","year":"2004","journal-title":"Nat. Clin. Pract. Cardiovasc. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S0140-6736(08)61236-2","article-title":"Renal Outcomes with Telmisartan, Ramipril, or Both, in People at High Vascular Risk (the ONTARGET Study): A Multicentre, Randomised, Double-Blind, Controlled Trial","volume":"372","author":"Mann","year":"2008","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Mochel, J.P. (2024). Renin\u2013Angiotensin\u2013Aldosterone System Modulation and Cardiovascular\u2013Kidney\u2013Metabolic Health. Preprints.","DOI":"10.20944\/preprints202406.2075.v1"},{"key":"ref_22","first-page":"689360","article-title":"The Renin\u2013Angiotensin\u2013Aldosterone System in Vascular Inflammation and Remodeling","volume":"2014","author":"Pacurari","year":"2014","journal-title":"Int. J. Inflamm."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/S0031-6997(24)01434-0","article-title":"Molecular and Cellular Mechanisms of Angiotensin II-Mediated Cardiovascular and Renal Diseases","volume":"52","author":"Kim","year":"2000","journal-title":"Pharmacol. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1152\/advan.00190.2016","article-title":"Cardiopulmonary Physiology: Why the Heart and Lungs are Inextricably Linked","volume":"41","author":"Verhoeff","year":"2017","journal-title":"Adv. Physiol. Educ."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Capric, V., Chandrakumar, H.P., Celenza-Salvatore, J., and Makaryus, A.N. (2021). The Role of the Renin\u2013Angiotensin\u2013Aldosterone System in Cardiovascular Disease: Pathogenetic Insights and Clinical Implications, IntechOpen.","DOI":"10.5772\/intechopen.96415"},{"key":"ref_26","unstructured":"Powell, J.R. (2011). Aldosterone and the Cardiovascular Complications of Chronic Kidney Disease. [Ph.D. Thesis, University of Glasgow]. Available online: https:\/\/theses.gla.ac.uk\/2306\/."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"H670","DOI":"10.1152\/ajpheart.00419.2023","article-title":"Aldosterone and Aldosterone Synthase Inhibitors in Cardiorenal Disease","volume":"326","author":"Verma","year":"2023","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Tyrankiewicz, U., Kij, A., Mohaissen, T., Olkowicz, M., Smolenski, R.T., and Chlopicki, S. (2019). Renin\u2013Angiotensin\u2013Aldosterone System in Heart Failure: Focus on Nonclassical Angiotensin Pathways as Novel Upstream Targets Regulating Aldosterone. Heart Failure Research, IntechOpen.","DOI":"10.5772\/intechopen.87239"},{"key":"ref_29","first-page":"1487","article-title":"The ACE2\/Ang(1\u20137)\/Mas Receptor Axis in Cardiovascular and Renal Diseases","volume":"70","author":"Kanda","year":"2012","journal-title":"Nihon Rinsho"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"45","DOI":"10.32593\/jstmu\/Vol6.Iss1.224","article-title":"The Cardiovascular System\u2019s Renin\u2013Angiotensin\u2013Aldosterone System (RAAS)","volume":"6","author":"Abbod","year":"2023","journal-title":"J. Shifa Tameer-e-Millat Univ."},{"key":"ref_31","first-page":"79","article-title":"L\u2019aldost\u00e9rone et ses Antagonistes dans l\u2019Insuffisance Cardiaque","volume":"32","author":"Lopes","year":"2003","journal-title":"Presse Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2985","DOI":"10.1681\/ASN.2006040356","article-title":"Renin\u2013Angiotensin\u2013Aldosterone System and Progression of Renal Disease","volume":"17","author":"Wolf","year":"2006","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_33","first-page":"3024","article-title":"Correlation between Urinary Angiotensinogen (AGT) and Albuminuria in Chronic Kidney Disease (CKD)","volume":"9","author":"Ali","year":"2024","journal-title":"Int. J. Innov. Sci. Res. Technol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1038\/jhh.2013.55","article-title":"Hypertension and Kidneys: Unraveling Complex Molecular Mechanisms Underlying Hypertensive Renal Damage","volume":"28","author":"Mennuni","year":"2014","journal-title":"J. Hum. Hypertens."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e108","DOI":"10.1161\/ATVBAHA.117.309813","article-title":"Endothelial Functions","volume":"37","author":"Godo","year":"2017","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1007\/s00395-024-01085-7","article-title":"Oxidative Stress Initiates Hemodynamic Change in CKD-Induced Heart Disease","volume":"119","author":"Sen","year":"2024","journal-title":"Basic Res. Cardiol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Podkowi\u0144ska, A., and Formanowicz, D. (2020). Chronic Kidney Disease as Oxidative Stress- and Inflammatory-Mediated Cardiovascular Disease. Antioxidants, 9.","DOI":"10.3390\/antiox9080752"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"902","DOI":"10.2174\/1389450123666220303090413","article-title":"Oxidative Stress: Meeting Multiple Targets in Pathogenesis of Vascular Endothelial Dysfunction","volume":"23","author":"Gupta","year":"2022","journal-title":"Curr. Drug Targets"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Higashi, Y. (2022). Roles of Oxidative Stress and Inflammation in Vascular Endothelial Dysfunction-Related Disease. Antioxidants, 11.","DOI":"10.3390\/antiox11101958"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1007\/s00109-021-02037-7","article-title":"Vascular Pathologies in Chronic Kidney Disease: Pathophysiological Mechanisms and Novel Therapeutic Approaches","volume":"99","author":"Zietzer","year":"2021","journal-title":"J. Mol. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1161\/01.ATV.0000122852.22604.78","article-title":"Is Oxidative Stress the Pathogenic Mechanism Underlying Insulin Resistance, Diabetes and Cardiovascular Disease? The Common Soil Hypothesis Revisited","volume":"24","author":"Ceriello","year":"2004","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"107255","DOI":"10.1016\/j.vph.2023.107255","article-title":"Inflammation and the Pathogenesis of Atherosclerosis","volume":"154","author":"Libby","year":"2024","journal-title":"Vasc. Pharmacol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1093\/ndt\/gfz055","article-title":"Most Exposed: The Endothelium in Chronic Kidney Disease","volume":"35","author":"Cuenca","year":"2020","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"6043601","DOI":"10.1155\/2016\/6043601","article-title":"New Pathogenic Concepts and Therapeutic Approaches to Oxidative Stress in Chronic Kidney Disease","volume":"2016","author":"Tapia","year":"2016","journal-title":"Oxidative Med. Cell. Longev."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Roumeliotis, S., Neofytou, I.E., Kantartzi, K., Georgianos, P.I., and Liakopoulos, V. (2024). Supplementation of Antioxidants in Chronic Kidney Disease: Clinical Necessity or Wishful Thinking? A Bench to Bedside Translational Research. Curr. Med. Chem., 31.","DOI":"10.2174\/0109298673298815240605071808"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1111\/j.1474-9726.2008.00438.x","article-title":"Aging Is Associated with Greater Nuclear NF-\u03baB, Reduced I\u03baB\u03b1, and Increased Expression of Proinflammatory Cytokines in Vascular Endothelial Cells of Healthy Humans","volume":"7","author":"Donato","year":"2008","journal-title":"Aging Cell"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.vph.2015.06.009","article-title":"Homocysteine, Methylenetetrahydrofolate Reductase, Folate Status and Atherothrombosis: A Mechanistic and Clinical Perspective","volume":"78","author":"Santilli","year":"2016","journal-title":"Vasc. Pharmacol."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Watral, J., Formanowicz, D., Perek, B., Kostka-Jeziorny, K., Podkowi\u0144ska, A., Tykarski, A., and Luczak, M. (2024). Comprehensive Proteomics of Monocytes Indicates Oxidative Imbalance Functionally Related to Inflammatory Response in Chronic Kidney Disease-Related Atherosclerosis. Front. Mol. Biosci., 11.","DOI":"10.3389\/fmolb.2024.1229648"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1681\/ASN.0000000000000083","article-title":"Chronic Kidney Disease Is Characterized by Expansion of a Distinct Proinflammatory Intermediate Monocyte Subtype and by Increased Monocyte Adhesion to Endothelial Cells","volume":"34","author":"Cormican","year":"2023","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Sun, Y., Sun, H., Zhang, Z., Tan, F., Qu, Y., Lei, X., Xu, Q., Wang, J., Shu, L., and Xiao, H. (2024). New insight into oxidative stress and inflammatory responses to kidney stones: Potential therapeutic strategies with natural active ingredients. Biomed. Pharmacother., 179.","DOI":"10.1016\/j.biopha.2024.117333"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1007\/s00467-008-1046-0","article-title":"Inflammation in Chronic Kidney Disease: Role in the Progression of Renal and Cardiovascular Disease","volume":"24","author":"Silverstein","year":"2009","journal-title":"Pediatr. Nephrol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1093\/ckj\/sfad135","article-title":"Leukocyte\u2013Endothelial Interaction in CKD","volume":"16","author":"Sarakpi","year":"2023","journal-title":"Clin. Kidney J."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"52","DOI":"10.31083\/j.rcm2402052","article-title":"The Molecular Mechanism and Therapeutic Strategy of Cardiorenal Syndrome Type 3","volume":"24","author":"Liu","year":"2023","journal-title":"Rev. Cardiovasc. Med."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Turner, C.M., Arulkumaran, N., Singer, M., Unwin, R.J., and Tam, F.W. (2014). Is the inflammasome a potential therapeutic target in renal disease?. BMC Nephrol., 15.","DOI":"10.1186\/1471-2369-15-21"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Sharma, A., Tate, M., Mathew, G., Vince, J.E., Ritchie, R.H., and de Haan, J.B. (2018). Oxidative Stress and NLRP3-Inflammasome Activity as Significant Drivers of Diabetic Cardiovascular Complications: Therapeutic Implications. Front. Physiol., 9.","DOI":"10.3389\/fphys.2018.00114"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1042\/CS20210865","article-title":"Adverse renal effects of NLRP3 inflammasome inhibition by MCC950 in an interventional model of diabetic kidney disease","volume":"136","author":"Jha","year":"2022","journal-title":"Clin. Sci."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Gonzalez-Lafuente, L., Mercado-Garcia, E., Vazquez-Sanchez, S., Gonzalez-Moreno, D., Poveda, J., Liano, F., Pelegrin, P., Fernandez-Velasco, M., and Ruiz-Hurtado, G. (2024). Role of NLRP3 inflammasome in cardiac damage in the setting of an acute cardiorenal syndrome. Cardiovasc. Res., 120.","DOI":"10.1093\/cvr\/cvae088.038"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Amador-Mart\u00ednez, I., Aparicio-Trejo, O.E., Bernabe-Yepes, B., Aranda-Rivera, A.K., Cruz-Gregorio, A., S\u00e1nchez-Lozada, L.G., Pedraza-Chaverri, J., and Tapia, E. (2023). Mitochondrial Impairment: A Link for Inflammatory Responses Activation in the Cardiorenal Syndrome Type 4. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms242115875"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Rayego-Mateos, S., Marquez-Exposito, L., Basantes, P., Tejedor-Santamaria, L., Sanz, A.B., Nguyen, T.Q., Goldschmeding, R., Ortiz, A., and Ruiz-Ortega, M. (2023). CCN2 Activates RIPK3, NLRP3 Inflammasome, and NRF2\/Oxidative Pathways Linked to Kidney Inflammation. Antioxidants, 12.","DOI":"10.3390\/antiox12081541"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"6679100","DOI":"10.1155\/2021\/6679100","article-title":"Nlrp3 Deficiency Alleviates Angiotensin II-Induced Cardiomyopathy by Inhibiting Mitochondrial Dysfunction","volume":"2021","author":"Chen","year":"2021","journal-title":"Oxidative Med. Cell. Longev."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"103576","DOI":"10.1016\/j.autrev.2024.103576","article-title":"The Role of Mitochondrial Dysfunction in Kidney Injury and Disease","volume":"23","author":"Jia","year":"2024","journal-title":"Autoimmun. Rev."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/1721727X241227349","article-title":"Development of Mitochondrial Dysfunction and Oxidative Stress in Chronic Kidney Disease","volume":"22","author":"Blagov","year":"2024","journal-title":"Eur. J. Inflamm."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Wang, Y., Yang, J., Zhang, Y., and Zhou, J. (2024). Focus on Mitochondrial Respiratory Chain: Potential Therapeutic Target for Chronic Renal Failure. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25020949"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1159\/000530485","article-title":"From Physiology to Pathology: The Role of Mitochondria in Acute Kidney Injuries and Chronic Kidney Diseases","volume":"9","author":"Zhang","year":"2023","journal-title":"Kidney Dis."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Ho, H.J., and Shirakawa, H. (2022). Oxidative Stress and Mitochondrial Dysfunction in Chronic Kidney Disease. Cells, 12.","DOI":"10.3390\/cells12010088"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"F768","DOI":"10.1152\/ajprenal.00189.2023","article-title":"Mitochondrial Dysfunction in the Pathophysiology of Renal Diseases","volume":"326","author":"Guo","year":"2024","journal-title":"Am. J. Physiol. Ren. Physiol."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Zhang, X., Agborbesong, E., and Li, X. (2021). The Role of Mitochondria in Acute Kidney Injury and Chronic Kidney Disease and Its Therapeutic Potential. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms222011253"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"244","DOI":"10.23876\/j.krcp.20.082","article-title":"Mitochondrial Dysfunction in Kidney Injury, Inflammation, and Disease: Potential Therapeutic Approaches","volume":"39","author":"Bhatia","year":"2020","journal-title":"Kidney Res. Clin. Pract."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1097\/MNH.0000000000000700","article-title":"New Insights into Muscle Function in Chronic Kidney Disease and Metabolic Acidosis","volume":"30","author":"Chalupsky","year":"2021","journal-title":"Curr. Opin. Nephrol. Hypertens."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"8209","DOI":"10.3390\/ijms24098209","article-title":"Mitochondrial Dysfunction in the Cardio\u2013Renal Axis","volume":"24","author":"Oller","year":"2023","journal-title":"Int. J. Mol. Sci."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1007\/s00109-010-0663-9","article-title":"Mitochondrial Biogenesis in the Metabolic Syndrome and Cardiovascular Disease","volume":"88","author":"Ren","year":"2010","journal-title":"J. Mol. Med."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Cojocaru, K., Luchian, I., Goriuc, A., Antoci, L., Ciobanu, C., Popescu, R., Vlad, C., Blaj, M., and Foia, L. (2023). Mitochondrial Dysfunction, Oxidative Stress, and Therapeutic Strategies in Diabetes, Obesity, and Cardiovascular Disease. Antioxidants, 12.","DOI":"10.3390\/antiox12030658"},{"key":"ref_73","first-page":"1328","article-title":"Role of Mitochondrial Dysfunction in Related Diseases\u2014A Review","volume":"4","author":"Yousaf","year":"2024","journal-title":"J. Health Rehabil. Res."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Ge, M., Fontanesi, F., Merscher, S., and Fornoni, A. (2020). The Vicious Cycle of Renal Lipotoxicity and Mitochondrial Dysfunction. Front. Physiol., 11.","DOI":"10.3389\/fphys.2020.00732"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Lumpuy-Castillo, J., Amador-Mart\u00ednez, I., D\u00edaz-Rojas, M., Lorenzo, O., Pedraza-Chaverri, J., S\u00e1nchez-Lozada, L.G., and Aparicio-Trejo, O.E. (2024). Role of Mitochondria in Reno-Cardiac Diseases: A Study of Bioenergetics, Biogenesis, and GSH Signaling in Disease Transition. Redox Biol., 76.","DOI":"10.1016\/j.redox.2024.103340"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1038\/s41419-024-06833-0","article-title":"Mitochondrial Metabolic Reprogramming in Diabetic Kidney Disease","volume":"15","author":"Fan","year":"2024","journal-title":"Cell Death Dis."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.nefroe.2022.11.011","article-title":"Consensus Document on Autosomal Dominant Polycystic Kidney Disease from the Spanish Working Group on Inherited Kidney Diseases. Review 2020","volume":"42","author":"Ars","year":"2022","journal-title":"Nefrolog\u00eda (Engl. Ed.)"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"S63","DOI":"10.1016\/j.pulmoe.2021.08.013","article-title":"Distinct TNF-alpha and HLA polymorphisms associate with fibrotic and non-fibrotic subtypes of hypersensitivity pneumonitis","volume":"29","author":"Freitas","year":"2023","journal-title":"Pulmonology"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1159\/000501703","article-title":"Association between the ACYP2 Polymorphisms and IgAN Risk in the Chinese Han Population","volume":"44","author":"Jin","year":"2019","journal-title":"Kidney Blood Press. Res."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"e024139","DOI":"10.1161\/JAHA.121.024139","article-title":"Cardiorenal Nexus: A Review With Focus on Combined Chronic Heart and Kidney Failure, and Insights From Recent Clinical Trials","volume":"11","author":"McCullough","year":"2022","journal-title":"J. Am. Heart Assoc."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1161\/HYPERTENSIONAHA.108.128116","article-title":"Cardiovascular Protection with Antihypertensive Drugs in Dialysis Patients: Systematic Review and Meta-Analysis","volume":"53","author":"Agarwal","year":"2009","journal-title":"Hypertension"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"e004536","DOI":"10.1161\/JAHA.116.004536","article-title":"Implications of Blood Pressure Measurement Technique for Implementation of Systolic Blood Pressure Intervention Trial (SPRINT)","volume":"6","author":"Agarwal","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1056\/NEJMoa2024816","article-title":"Dapagliflozin in Patients with Chronic Kidney Disease","volume":"383","author":"Heerspink","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_84","unstructured":"Challa, H.J., Ameer, M.A., and Uppaluri, K.R. (2023). DASH Diet to Stop Hypertension. StatPearls, StatPearls Publishing."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.2215\/CJN.11491116","article-title":"Diabetic Kidney Disease: Challenges, Progress, and Possibilities","volume":"12","author":"Alicic","year":"2017","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"106948","DOI":"10.1016\/j.prostaglandins.2025.106948","article-title":"Associations between Omega-3 Fatty Acid-Derived Lipid Mediators and Markers of Inflammation in Older Subjects with Low-Grade Chronic Inflammation","volume":"176","year":"2025","journal-title":"Prostaglandins Other Lipid Mediat."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"e2070012","DOI":"10.1002\/mnfr.202070012","article-title":"EPA+DHA, but Not ALA, Improved Lipids and Inflammation Status in Hypercholesterolemic Adults: A Randomized, Double-Blind, Placebo-Controlled Trial","volume":"64","author":"Zhou","year":"2020","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"107553","DOI":"10.1016\/j.jdiacomp.2020.107553","article-title":"Fish Oil Reduces Subclinical Inflammation, Insulin Resistance, and Atherogenic Factors in Overweight\/Obese Type 2 Diabetes Mellitus Patients: A Pre\u2013Post Pilot Study","volume":"34","author":"Souza","year":"2020","journal-title":"J. Diabetes Complicat."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Lamantia, V., Bissonnette, S., Beaudry, M., Cyr, Y., Rosiers, C.D., Baass, A., and Faraj, M. (2024). EPA and DHA Inhibit LDL-Induced Upregulation of Human Adipose Tissue NLRP3 Inflammasome\/IL-1\u03b2 Pathway and Its Association with Diabetes Risk Factors. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-73672-6"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1111\/dom.14916","article-title":"Chronic kidney disease begets heart failure and vice versa: Temporal associations between heart failure events in relation to incident chronic kidney disease in type 2 diabetes","volume":"25","author":"Wu","year":"2023","journal-title":"Diabetes Obes. Metab."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1016\/j.xkme.2021.07.010","article-title":"Marine n-3 Polyunsaturated Fatty Acids and Cellular Senescence Markers in Incident Kidney Transplant Recipients: The Omega-3 Fatty Acids in Renal Transplantation (ORENTRA) Randomized Clinical Trial","volume":"3","author":"Chan","year":"2021","journal-title":"Kidney Med."},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Tiscornia, C., Tapia, V., \u00c1guila, D., Lorca-Ponce, E., Aicardi, V., and V\u00e1squez, F. (2025). Maqui and Chronic Kidney Disease: A Narrative Review on the Potential Nephroprotective Role of Anthocyanins. Nutrients, 17.","DOI":"10.3390\/nu17061058"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1080\/07315724.2015.1080108","article-title":"A Randomized Clinical Trial Evaluating the Efficacy of an Anthocyanin\u2013Maqui Berry Extract (Delphinol\u00ae) on Oxidative Stress Biomarkers","volume":"34","author":"Davinelli","year":"2015","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Alvarado, J.L., Leschot, A., Olivera-Nappa, \u00c1., Salgado, A.M., Rioseco, H., Lyon, C., and Vigil, P. (2016). Delphinidin-Rich Maqui Berry Extract (Delphinol\u00ae) Lowers Fasting and Postprandial Glycemia and Insulinemia in Prediabetic Individuals During Oral Glucose Tolerance Tests. Biomed. Res. Int., 2016.","DOI":"10.1155\/2016\/9070537"},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"D\u2019andurain, J., L\u00f3pez, V., Arazo-Rusindo, M., Tiscornia, C., Aicardi, V., Sim\u00f3n, L., and Arazo-Rusindo, M.S. (2023). Effect of Curcumin Consumption on Inflammation and Oxidative Stress in Patients on Hemodialysis: A Literature Review. Nutrients, 15.","DOI":"10.3390\/nu15102239"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"9183","DOI":"10.3390\/molecules20059183","article-title":"Curcumin, Inflammation, and Chronic Diseases: How Are They Linked?","volume":"20","author":"He","year":"2015","journal-title":"Molecules"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.clnesp.2017.09.006","article-title":"Evaluation of Curcumin\u2019s Effect on Inflammation in Hemodialysis Patients","volume":"22","author":"Samadian","year":"2017","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Rittiner, J., Cumaran, M., Malhotra, S., and Kantor, B. (2022). Therapeutic Modulation of Gene Expression in the Disease State: Treatment Strategies and Approaches for the Development of Next-Generation of the Epigenetic Drugs. Front. Bioeng. Biotechnol., 10.","DOI":"10.3389\/fbioe.2022.1035543"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"101333","DOI":"10.1016\/j.omtm.2024.101333","article-title":"Gene Therapy and Kidney Diseases","volume":"32","author":"Tavakolidakhrabadi","year":"2024","journal-title":"Mol. Ther. Methods Clin. Dev."},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Huang, C.-K., B\u00e4r, C., and Thum, T. (2020). miR-21, Mediator, and Potential Therapeutic Target in the Cardiorenal Syndrome. Front. Pharmacol., 11.","DOI":"10.3389\/fphar.2020.00726"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1172\/JCI62837","article-title":"Potential of gene therapy as a treatment for heart failure","volume":"123","author":"Hajjar","year":"2013","journal-title":"J. Clin. Investig."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1093\/cvr\/cvv205","article-title":"Gene therapy for cardiovascular disease: Advances in vector development, targeting, and delivery for clinical translation","volume":"108","author":"Rincon","year":"2015","journal-title":"Cardiovasc. Res."},{"key":"ref_103","first-page":"129","article-title":"Cell-Specific Targeting of the Endothelium in the Cardiorenal Syndrome","volume":"14","author":"Laakkonen","year":"2024","journal-title":"Cardiorenal Med."},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Buliga-Finis, O.N., Ouatu, A., Badescu, M.C., Dima, N., Tanase, D.M., Richter, P., and Rezus, C. (2022). Beyond the Cardiorenal Syndrome: Pathophysiological Approaches and Biomarkers for Renal and Cardiac Crosstalk. Diagnostics, 12.","DOI":"10.3390\/diagnostics12040773"},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Gallo, G., Lanza, O., and Savoia, C. (2023). New Insight in Cardiorenal Syndrome: From Biomarkers to Therapy. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24065089"},{"key":"ref_106","doi-asserted-by":"crossref","unstructured":"Moldovan, D., Rusu, C., Potra, A., Tirinescu, D., Ticala, M., and Kacso, I. (2024). Food to Prevent Vascular Calcification in Chronic Kidney Disease. Nutrients, 16.","DOI":"10.3390\/nu16050617"},{"key":"ref_107","doi-asserted-by":"crossref","unstructured":"Calvo, M.S., and Uribarri, J. (2023). Industrial use of phosphate food additives: A mechanism linking ultra-processed food consumption with cardio-renal disease. Nutrients, 15.","DOI":"10.3390\/nu15163510"},{"key":"ref_108","first-page":"e64404","article-title":"Role of Magnesium, Effects of Hypomagnesemia, and Benefits of Magnesium Supplements in Cardiovascular and Chronic Kidney Diseases","volume":"16","author":"Panta","year":"2024","journal-title":"Cureus"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1053\/j.ajkd.2020.05.006","article-title":"KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update","volume":"76","author":"Ikizler","year":"2020","journal-title":"Am. J. Kidney Dis."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1007\/s40620-019-00601-6","article-title":"Serum Magnesium, Mortality, and Cardiovascular Disease in Chronic Kidney Disease and End-Stage Renal Disease Patients: A Systematic Review and Meta-Analysis","volume":"32","author":"Xiong","year":"2019","journal-title":"J. Nephrol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1093\/advances\/nmaa027","article-title":"Dietary Potassium Intake and Risk of Chronic Kidney Disease Progression in Predialysis Patients with Chronic Kidney Disease: A Systematic Review","volume":"11","author":"Picard","year":"2020","journal-title":"Adv. Nutr."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"4780","DOI":"10.1210\/jc.2012-2852","article-title":"Diabetes Control and Complications Trial\/Epidemiology of Diabetes Interventions and Complications Study Research Group. Circulating Vitamin D Metabolites and Kidney Disease in Type 1 Diabetes","volume":"97","author":"Sachs","year":"2012","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1093\/ajcn\/85.1.96","article-title":"Nutritional Status in Patients with Diabetes and Chronic Kidney Disease: A Prospective Study","volume":"85","author":"Raffaitin","year":"2007","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1053\/j.jrn.2023.06.006","article-title":"Dietary Intake and Nutritional Status in Diabetic and Nondiabetic Patients with Chronic Kidney Disease Stage 4\u20135 (NutriDiab Study)","volume":"34","author":"Oliveira","year":"2024","journal-title":"J. Ren. Nutr."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/15\/7440\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:21:01Z","timestamp":1760034061000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/15\/7440"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,1]]},"references-count":114,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["ijms26157440"],"URL":"https:\/\/doi.org\/10.3390\/ijms26157440","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,1]]}}}