This reported change in structure and
function of glomerular tight junctions with the loss of ESAM points
to its pivotal role in normal kidney homeostasis. It is therefore
plausible that ESAM might represent one pathophysiological link
shared by CKD (loss of glomerular homeostasis) and CVD (loss of
vascular homeostasis). A statistical adjustment for ESAM-mediated
renal disease might then be expected to weaken any association
between sESAM and cardiovascular outcomes.