Beyond a Passive Conduit: Implications of Lymphatic Biology for Kidney Diseases

J Am Soc Nephrol. 2020 Jun;31(6):1178-1190. doi: 10.1681/ASN.2019121320. Epub 2020 Apr 15.

Abstract

The kidney contains a network of lymphatic vessels that clear fluid, small molecules, and cells from the renal interstitium. Through modulating immune responses and via crosstalk with surrounding renal cells, lymphatic vessels have been implicated in the progression and maintenance of kidney disease. In this Review, we provide an overview of the development, structure, and function of lymphatic vessels in the healthy adult kidney. We then highlight the contributions of lymphatic vessels to multiple forms of renal pathology, emphasizing CKD, transplant rejection, and polycystic kidney disease and discuss strategies to target renal lymphatics using genetic and pharmacologic approaches. Overall, we argue the case for lymphatics playing a fundamental role in renal physiology and pathology and treatments modulating these vessels having therapeutic potential across the spectrum of kidney disease.

Keywords: cell signaling; endothelial cells; kidney development; kidney disease; pathophysiology of renal disease and progression; renal cell biology.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adaptive Immunity
  • Graft Rejection
  • Humans
  • Kidney Diseases / etiology*
  • Kidney Diseases / physiopathology
  • Kidney Transplantation / adverse effects
  • Lymph / physiology
  • Lymphangiogenesis
  • Lymphatic Vessels / anatomy & histology
  • Lymphatic Vessels / cytology
  • Lymphatic Vessels / physiology*
  • Polycystic Kidney Diseases / physiopathology
  • Vascular Endothelial Growth Factor A / physiology

Substances

  • Vascular Endothelial Growth Factor A