Sirtuins and Resveratrol in Cardiorenal Diseases: A Narrative Review of Mechanisms and Therapeutic Potential

Aging is a very complex process and it has been linked with Sirtuins. Sirtuin enzymes are a family of deacetylases that are related with caloric restriction and aging by modulating energy metabolism, genomic stability and stress resistance. Up to now, seven sirtuins have been recognized. Our purpose is to clarify the role of sirtuins in Chronic Kidney Disease (CKD). Moreover, as heart and kidney diseases are strictly interrelated, we’re going to explore their role in heart diseases and cardio-renal cross-talk. A reciprocal relationship between CKD and aging seems to exist, since CKD may contribute to premature biological aging of different organ systems. SIRTs are involved in pathophysiology of renal diseases; their activation can delay the progression of several renal diseases. Cardiovascular diseases (CVDs) are the leading cause of global mortality and a major contributor to disability. Notably, an increasing number of studies linked SIRTs with different CVDs. SIRTs affect the production of mitochondrial reactive oxygen species (ROS) by modulating mitochondrial function. The imbalance of SIRTs levels may increase the vulnerability to CVDs. SIRTs are involved in pathophysiological mechanisms of HFpEF (heart failure with preserved ejection fraction) through different signalling pathways. Fibrosis is the linkage mechanism between heart and kidney in the development of cardio-renal diseases. Different natural SIRT1 agonists showed renoprotective effects and among these Resveratrol (RSV) and other phenolic compounds have been widely investigated with interesting and positive results. Future research is obviously needed to clarify the role of these molecules and their potential therapeutical role in heart and kidney diseases.