CIRCADIAN CONTROL OF RENAL FUNCTION: ADVANCES AND PERSPECTIVES IN KIDNEY PHYSIOLOGY -A REVIEW

Abstract

Circadian rhythms govern nearly every aspect of renal physiology, from glomerular filtration and tubular transport to hormone secretion and metabolic regulation. The kidney’s intrinsic molecular clocks synchronize these processes with systemic cues, ensuring temporal homeostasis. Disruption of this coordination through shift work, sleep loss, or chronic disease leads to sodium imbalance, non-dipping hypertension, and accelerated chronic kidney disease (CKD) progression. Multi-omic and imaging advances have revealed extensive rhythmic gene, protein, and metabolite networks within the kidney, underscoring time as a key biological variable. Clinically, these findings inform the emerging field of chronotherapy, where the timing of antihypertensive, diuretic, or immunosuppressive administration enhances efficacy and minimizes toxicity. Future chrononephrology research integrating single-cell temporal mapping, wearable biosensing, and AI-driven modeling promises to transform renal precision medicine by aligning diagnostics and therapeutics with the body’s internal clock.