FIGURE 8.

Summary. Chronic kidney disease induces volume retention and upregulation of urea transport. Volume retention cause hypertension leading to cardiac hypertrophy. Upregulation of urea transport increases the RAS and results in hypertension. The increase in the RAS also promotes fibroblast and acquisition of α-SMA expression and results in their becoming myofibroblasts. These myofibroblastic cells synthesize and deposit the extracellular matrix (ECM) components leading to heart fibrosis. In CKD, inhibition of urea transport attenuates hypertension and limits cardiac hypertrophy and fibrosis