Microvascular dysfunction and kidney disease: Challenges and opportunities?

Suraj Krishnan, Ariana D. Suarez-Martinez, Pooneh Bagher, Anjelica Gonzalez, Ruisheng Liu, Walter L. Murfee, Rajesh Mohandas

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Kidneys are highly vascular organs that despite their relatively small size receive 20% of the cardiac output. The highly intricate, delicately organized structure of renal microcirculation is essential to enable renal function and glomerular filtration rate through the local modulation of renal blood flow and intraglomerular pressure. Not surprisingly, the dysregulation of blood flow within the microvessels (abnormal vasoreactivity), fibrosis driven by disordered vascular-renal cross talk, or the loss of renal microvasculature (rarefaction) is associated with kidney disease. In addition, kidney disease can cause microcirculatory dysfunction in distant organs such as the heart and brain, mediated by mechanisms that remain to be elucidated. The objective of this review is to highlight the role of renal microvasculature in kidney disease. The overview will outline the impetus to study renal microvasculature, the bidirectional relationship between kidney disease and microvascular dysfunction, the key pathways driving microvascular diseases such as vasoreactivity, the cell dynamics coordinating fibrosis, and vessel rarefaction. Finally, we will also briefly highlight new therapies targeting the renal microvasculature to improve renal function.

Original languageEnglish (US)
Article numbere12661
Issue number3
StatePublished - Apr 2021
Externally publishedYes


  • endothelial cell
  • fibroblast
  • fibrosis
  • kidney
  • microcirculation
  • pericyte
  • rarefaction
  • vasoreactivity

ASJC Scopus subject areas

  • Physiology
  • Molecular Biology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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