Integrative Determinants of Chronic Kidney Disease: Psychodynamic Stress, Nutritional Dysregulation, and Environmental Toxicity as Emerging Pharmacological Targets
Abstract
Even if hemodynamic and metabolic treatments for Chronic Kidney Disease (CKD) have been shown to work, there is still a significant risk of progression to End-Stage Kidney Disease. This paper asserts that the ongoing deterioration is influenced by a "integrative toxic milieu" defined by three neglected factors: psychodynamic stress, dietary dysregulation, and environmental toxicity. By combining data from important recent trials like TACT2, VALOR-CKD, and AYAME, we look at the molecular pathways that link these factors to renal fibrosis. We focus on the Psycho-Neuro-Endocrine-Immune (PNEI) and gut-kidney axes. The review also looks at how well new drugs like aldosterone synthase inhibitors, Nrf2 activators, and chelation therapies work. It makes the case for a shift in thinking toward a more comprehensive, multi-target pharmacological approach that goes beyond just the glomeruli to include the patient's overall responses to stress from their environment and their own body.
Keywords: Chronic Kidney Disease, Renal Fibrosis, Gut-Kidney Axis, PNEI Axis (Psycho-Neuro-Endocrine-Immune), Nrf2 Pathway, Environmental Nephrotoxicity
Keywords:
Chronic Kidney Disease, Renal Fibrosis, Gut-Kidney Axis, PNEI Axis (Psycho-Neuro-Endocrine-Immune), Nrf2 Pathway, Environmental NephrotoxicityDOI
https://doi.org/10.22270/jddt.v16i5.7760References
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