Tubulointerstitial injury and the progression of chronic kidney disease.

Tubulointerstitial injury and the progression of chronic kidney disease.
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DOI:
10.1007/s00467-011-1992-9
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发表时间:
2012-06
影响因子:
3
通讯作者:
Schnaper, H. William
Schnaper, H. William
中科院分区:
医学3区
文献类型:
--
作者:
Hodgkins, Kavita S.;Schnaper, H. William

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在慢性肾脏病(CKD)中,一旦任何数量的疾病过程造成的损伤达到某个阈值,就会出现一个明显不可逆转的肾功能下降过程。小管间质可能在这一常见的进展途径中发挥关键作用。直接损伤、高代谢需求或各种其他形式的肾功能障碍刺激会激活肾小管上皮细胞。这些继而与间质组织元素和炎性细胞相互作用,导致肾实质进一步的病理变化。因此,组织对这些变化的反应产生了肾脏损伤和进行性功能丧失的前馈循环。本文就这种负循环调节慢性肾脏病的机制作一综述。
In chronic kidney disease (CKD), once injury from any number of disease processes reaches a threshold, there follows an apparently irreversible course toward decline in kidney function. The tubulointerstitium may play a key role in this common progression pathway. Direct injury, high metabolic demands, or stimuli from various other forms of renal dysfunction activate tubular cells. These, in turn, interact with interstitial tissue elements and inflammatory cells, causing further pathologic changes in the renal parenchyma. The tissue response to these changes thus generates a feed-forward loop of kidney injury and progressive loss of function. This article reviews the mechanisms of this negative cycle mediating CKD.
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