Chronic kidney disease (CKD) is a leading cause of global morbidity and mortality and is independently associated with cardiovascular disease. The mainstay of treatment for CKD is blockade of the renin–angiotensin–aldosterone system (RAAS), which reduces blood pressure and proteinuria and slows kidney function decline. Despite this treatment, many patients progress to kidney failure, which requires dialysis or kidney transplantation, and/or die as a result of cardiovascular disease. The apelin system is an endogenous physiological regulator that is emerging as a potential therapeutic target for many diseases. This system comprises the apelin receptor and its two families of endogenous ligands, apelin and elabela/toddler. Preclinical and clinical studies show that apelin receptor ligands are endothelium-dependent vasodilators and potent inotropes, and the apelin system has a reciprocal relationship with the RAAS. In preclinical studies, apelin regulates glomerular haemodynamics and acts on the tubule to promote aquaresis. In addition, apelin is protective in several kidney injury models. Although the apelin system has not yet been studied in patients with CKD, the available data suggest that apelin is a promising potential therapeutic target for kidney disease.

慢性肾脏病（CKD）是全球发病率和死亡率的主要原因，并且与心血管疾病独立相关。CKD 的主要治疗方法是阻断肾素-血管紧张素-醛固酮系统 (RAAS)，该系统可降低血压和蛋白尿，并减缓肾功能衰退。尽管进行了这种治疗，许多患者仍进展为肾衰竭，需要透析或肾移植，和/或因心血管疾病而死亡。apelin 系统是一种内源性生理调节因子，正在成为许多疾病的潜在治疗靶点。该系统包括 apelin 受体及其两个内源配体家族：apelin 和 elabela/toddler。临床前和临床研究表明apelin受体配体是内皮依赖性血管扩张剂和强效正性肌力药，apelin系统与RAAS具有相互关系。在临床前研究中，apelin 调节肾小球血流动力学并作用于肾小管以促进水渗出。此外，apelin 在多种肾损伤模型中具有保护作用。尽管 apelin 系统尚未在 CKD 患者中进行研究，但现有数据表明 apelin 是肾脏疾病有前途的潜在治疗靶点。