Role of iron in progressive renal disease.
Role of iron in progressive renal disease.
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DOI：
10.1053/ajkd.2001.20736
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
Sudhir V. Shah
中科院分区：
文献类型：
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作者：
Sudhir V. Shah
铁在肾损伤中的重要性来自铁可逆氧化或还原的容易性，使其能够参与自由基的产生。氧化剂和铁在进行性肾病中作用的实验证据分为两大类福尔斯。首先，大量的数据表明氧化剂参与肾小球疾病的蛋白尿。在某种程度上，蛋白尿是疾病进展的重要决定因素，蛋白尿减少将导致疾病进展延迟。证据还表明氧化剂和铁在糖尿病肾病中的作用，糖尿病肾病是终末期肾病的主要原因。其次，更直接的研究已经检查了氧化剂和铁在进行性肾病模型中的作用。这些研究包括在进行性肾病模型中证明肾脏中铁的增加;氧化剂的产生增加，提供了一种可以动员铁的机制;以及缺铁饮食和铁螯合剂的有益作用的更直接证据。虽然来自肾小球疾病和进行性肾衰竭的体外研究和动物模型的氧化剂和铁的作用的集体信息是令人印象深刻的，需要患者的对照研究，以显示抗氧化剂和/或铁螯合剂在延缓肾衰竭的进展，并可能提供一个重要的治疗模式，肾脏疾病患者的疗效。
The importance of iron in renal injury is derived from the ease with which iron is reversibly oxidized or reduced, enabling it to participate in the production of free radicals. Experimental evidence for the role of oxidants and iron in progressive renal disease falls into two broad categories. First, considerable data implicate oxidants in the proteinuria of glomerular disease. To the extent that proteinuria is an important determinant of progression, reduction of proteinuria would result in retardation of progression. Evidence also suggests a role of oxidants and iron in diabetic nephropathy, a major cause of end-stage kidney disease. Second, more direct studies have examined the role of oxidants and iron in models of progressive renal disease. These studies include the demonstration of increased iron in the kidney in models of progressive kidney disease; enhanced generation of oxidants, providing a mechanism by which iron can be mobilized; and more direct evidence of the beneficial effect of iron-deficient diets and iron chelators. Although the collective information on the role of oxidants and iron derived from in vitro studies and animal models of glomerular disease and progressive renal failure is impressive, control studies of patients are needed to show the efficacy of antioxidants and/or iron chelators in retarding the progression of renal failure and may offer an important therapeutic modality to patients with renal disease.