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.

中文翻译：

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微血管功能障碍和肾脏疾病：挑战和机遇？

肾脏是高度血管化的器官，尽管它们的体积相对较小，却能接收 20% 的心输出量。肾脏微循环的高度复杂、组织精细的结构对于通过局部调节肾血流量和肾小球内压来实现肾功能和肾小球滤过率至关重要。毫不奇怪，微血管内血流失调（血管反应性异常）、血管-肾脏串扰紊乱导致的纤维化或肾脏微血管系统的丧失（稀疏）与肾脏疾病有关。此外，肾脏疾病可引起心脏和大脑等远处器官的微循环功能障碍，其介导机制仍有待阐明。本综述的目的是强调肾脏微血管系统在肾脏疾病中的作用。概述将概述研究肾脏微血管系统的动力、肾脏疾病与微血管功能障碍之间的双向关系、驱动微血管疾病的关键途径，如血管反应性、细胞动力学协调纤维化和血管稀疏。最后，我们还将简要强调针对肾脏微血管系统以改善肾功能的新疗法。