Chronic kidney disease
Chronic kidney disease
复制标题
慢性肾脏病
DOI：
10.1038/nrdp.2017.88
复制
发表时间：
2017-11-23
影响因子：
81.5
通讯作者：
Anders, Hans-Joachim
中科院分区：
文献类型：
--
作者：
Romagnani, Paola;Remuzzi, Giuseppe;Anders, Hans-Joachim
慢性肾脏疾病（CKD）定义为持续性尿液异常、结构异常或排泄性肾功能受损，提示功能性肾单位丧失。大多数CKD患者有加速心血管疾病和死亡的风险。对于那些进展到终末期肾病的人来说，肾脏替代治疗的可及性有限是世界许多地区的一个问题。CKD发生和进展的风险因素包括出生时肾单位数量低、年龄增加导致的肾单位丢失以及毒性暴露或疾病（例如肥胖和2型糖尿病）导致的急性或慢性肾损伤。CKD患者的管理重点是早期发现或预防，治疗根本原因（如果可能）以抑制进展，并关注导致持续肾单位丢失的继发过程。控制血压、抑制肾素-血管紧张素系统和针对疾病的干预是治疗的基础。CKD并发症如贫血、代谢性酸中毒和继发性甲状旁腺功能亢进会影响心血管健康和生活质量，需要诊断和治疗。
Chronic kidney disease (CKD) is defined by persistent urine abnormalities, structural abnormalities or impaired excretory renal function suggestive of a loss of functional nephrons. The majority of patients with CKD are at risk of accelerated cardiovascular disease and death. For those who progress to end-stage renal disease, the limited accessibility to renal replacement therapy is a problem in many parts of the world. Risk factors for the development and progression of CKD include low nephron number at birth, nephron loss due to increasing age and acute or chronic kidney injuries caused by toxic exposures or diseases (for example, obesity and type 2 diabetes mellitus). The management of patients with CKD is focused on early detection or prevention, treatment of the underlying cause (if possible) to curb progression and attention to secondary processes that contribute to ongoing nephron loss. Blood pressure control, inhibition of the renin-angiotensin system and disease-specific interventions are the cornerstones of therapy. CKD complications such as anaemia, metabolic acidosis and secondary hyperparathyroidism affect cardiovascular health and quality of life, and require diagnosis and treatment.