Kidney Res Clin Pract.  2023 Sep;42(5):561-578. 10.23876/j.krcp.23.012.

The impact of hypoxia-inducible factors in the pathogenesis of kidney diseases: a link through cell metabolism

Affiliations
  • 1Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
  • 2Division of Nephrology, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil

Abstract

Kidneys are sensitive to disturbances in oxygen homeostasis. Hypoxia and activation of the hypoxia-inducible factor (HIF) pathway alter the expression of genes involved in the metabolism of renal and immune cells, interfering with their functioning. Whether the transcriptional activity of HIF protects the kidneys or participates in the pathogenesis of renal diseases is unclear. Several studies have indicated that HIF signaling promotes fibrosis in experimental models of kidney disease. Other reports showed a protective effect of HIF activation on kidney inflammation and injury. In addition to the direct effect of HIF on the kidneys, experimental evidence indicates that HIF-mediated metabolic shift activates inflammatory cells, supporting the HIF cascade as a link between lung or gut damage and worsening of renal disease. Although hypoxia and HIF activation are present in several scenarios of renal diseases, further investigations are needed to clarify whether interfering with the HIF pathway is beneficial in different pathological contexts.

Keyword

Cell metabolism; Gut-kidney axis; Hypoxia; Hypoxia-inducible factor 1; Immune cells; Kidney diseases; Lung-kidney axis
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