Remnant nephron physiology and the progression of chronic kidney disease.
Remnant nephron physiology and the progression of chronic kidney disease.
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DOI:
10.1007/s00467-013-2494-8
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发表时间:
2014-02
影响因子:
3
通讯作者:
Schnaper, H. William
中科院分区:
文献类型:
--
作者:
Schnaper, H. William
In chronic kidney disease, ongoing failure of individual nephrons leads to the progressive loss of renal function. This process results in part from a cellular and molecular response to injury that represents an attempt to maintain homeostasis but instead initiates a program that damages the nephron. As nephrons are lost, compensation by the remaining nephrons exacerbates glomerular pathophysiology. Delivery of excessive amounts of biologically active molecules to the distal nephron and tubulointerstitium generates inflammation and cellular dedifferentiation. Energy requirements of hyperfunctioning nephrons exceed the metabolic substrate available to the renal tubule, and inadequacy of the local vascular supply promotes hypoxia/ischemia and consequent acidosis and reactive oxygen species generation. In this way, mechanisms activated to maintain biological balance ultimately lead to demise of the nephron.
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