Renal insufficiency and chronic kidney disease – Promotor or consequence of pathological post-translational modifications

More than 840 million people, representing almost 10% of world population, were estimated to have chronic kidney disease (CKD) in 2017. In CKD, many systemic changes relative to oxidative stress, inflammation, energy balance or neuroendocrine signalling are observed and can be linked to dysfunctional proteins, including protein post-translational modifications (PTMs). Recent technical advances enabled the detection of PTMs and allowed understanding their participation in CKD pathophysiology and kidney damage. In this review article, the interconnections between CKD and PTMs, both as causes and consequences, are described. PTMs, particularly non-enzymatic PTMs, are frequently observed in CKD, as they are the direct consequence of systemic changes following the decline in kidney function. Other PTMs, mainly enzymatic ones, are critical for proper kidney physiology. Still, both types of PTMs have been shown to induce damage not only in kidney but also in other organs (brain, cardiovascular system). Therapeutic approaches focusing on metabolic changes responsible for PTMs alteration have shown interesting results. Targeting specific PTMs responsible for kidney damage is also being considered, which could lead to the development of innovative treatments.