Melatonin in the pathogenesis and treatment of chronic kidney disease

Chronic kidney disease (CKD) is widespread and occurs in 10-13 % of the world's population. For example, in the United States alone, according to the latest data, 37 million adult patients have been diagnosed with the disease. With this pathology, the physiological and biological mechanisms of homeostasis are affected (electrolyte and pH balance, regulation of blood pressure and the endocrine system, elimination of toxins, and metabolic disorders). The disease is irreversible, asymptomatic at the initial stages, gradually progresses and homeostasis disorders become clinically significant. Conservative nephroprotective therapy is performed at the initial stages. In the later stages, there is a need for replacement therapy (hemodialysis, peritoneal dialysis and kidney transplantation). The goal of conservative treatment of CKD is to slow the progression of renal pathology, as well as to correct complications from other organs and body systems (metabolic conditions, cardiovascular disorders, anemia, etc.). Unfortunately, the algorithms developed today for the treatment of CKD do not solve all the issues and force us to look for new, additional approaches to correcting certain pathological processes in CKD. It is from a pharmacotherapeutic perspective that melatonin (MT) has attracted attention in recent years, showing its ability to limit most manifestations of CKD. The purpose of this review is to summarize information about the potential use of MT in CKD, taking into account its positive effect on the cardiovascular system, diabetes, homeostasis, and a number of other conditions associated with renal pathology.