Erectile Dysfunction ED Drugs Have a Protective Effect on Kidneys and the Heart

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Abstract

The kidneys are vital organs that play an important role in removing waste materials from the blood, electrolyte balance, blood pressure regulation, and red blood cell genesis.
Kidney disease can be caused by various factors, including diabetes, ischemia/reperfusion injury, and nephrotoxic agents. Inflammation and oxidative stress play a key role in the progression and pathogenesis of kidney diseases. Acute kidney injury (AKI) and chronic kidney disease (CKD) are important health problems worldwide, as they are associated with a long-term hospital stay, and increased morbidity and mortality in high-risk patients. Current standard therapeutic options are not sufficient to delay or stop the loss of kidney function. Therefore, it is necessary to develop new therapeutic options. Phosphodiesterase 5 inhibitors (PDE5Is) are a currently available class of drugs that are used to treat erectile dysfunction and pulmonary hypertension in humans. However, recent evidence suggests that PDE5Is have beneficial renoprotective effects via a variety of mechanisms. In this review, the benefits of PDE5 inhibitors in clinical conditions associated with kidney diseases, such as diabetic nephropathy, ischemia-reperfusion injury, and acute and chronic kidney injury, are summarized.




Introduction

The kidney is a vital organ that has many functions, including electrolyte and volume regulation, elimination of nitrogenous wastes, elimination of exogenous molecules (e.g., many drugs), synthesis of various hormones (e.g., erythropoietin), and metabolism of low molecular weight proteins. Renal failure develops in cases where the kidneys fail to fulfill their excretory function or when there is an increase in nitrogenous waste products in the blood. There are two types of kidney failure, which are acute and chronic kidney failure [1].




*Phosphodiesterase 5 inhibitors

*The physiological role of PDE5 in the kidney

*Renoprotective effects of PDE5 inhibitors in diabetic nephropathy

*Renoprotective effects of PDE5 inhibitors in ischemia-reperfusion injury

*Renoprotective effects of PDE5 inhibitors in nephrotoxic nephropathy

*Renoprotective effects of PDE5 inhibitors in chronic kidney disease


*Side‑effects of PDE5I and future perspective




Conclusions

PDE5Is appears to be beneficial in renal diseases. They improve renal function and histopathological changes through a variety of mechanisms, including antioxidative, anti-inflammatory, anti-apoptotic, antifibrotic, and regional hemodynamic effects (Fig. 2).
Regardless of the type of renal damage and the agent administered, the reno-protective effect of PDE5Is was observed in the vast majority of studies. The results of animal studies are promising, although the data are still limited. The potential reno-protective capacity of PDE5Is should be supported by further animal and clinical studies.
 

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madman

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Fig. 1 cGMP signaling cascade. cGMP is produced by soluble guanylyl cyclases through nitric oxide activation. cGMP then activates cGMP-dependent protein kinase G, causing various cellular effects, such as growth, vitality, endothelial permeability, ion transport, smooth muscle relaxation, secretion, and gene transcription. PDE5 specifically, catabolize cGMP. PDE5I, on the other hand, increases the cGMP activity by inhibiting this effect of PDE5
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