Chronic kidney disease and premature ageing
Chronic kidney disease and premature ageing
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DOI：
10.1038/nrneph.2014.185
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发表时间：
2014-12-01
影响因子：
41.5
通讯作者：
Stenvinkel, Peter
中科院分区：
文献类型：
--
作者：
Kooman, Jeroen P.;Kotanko, Peter;Stenvinkel, Peter
慢性肾脏疾病（CKD）与其他慢性疾病（包括心力衰竭、慢性阻塞性肺病、HIV感染和类风湿性关节炎）有许多表型相似之处。最明显的相似之处是过早衰老，包括加速血管疾病和肌肉萎缩。我们提出，除了久坐不动的生活方式和社会心理和社会经济因素外，四种主要的疾病诱发机制是CKD过早衰老的基础：适应负荷增加、“应激抵抗反应”的激活、年龄促进机制的激活和抗衰老途径的损伤。目前最有效的调节早衰的干预措施——治疗潜在疾病、优化营养、纠正内环境和运动训练——减少全身炎症和氧化应激，诱导肌肉合成代谢。深入了解早衰现象的机制以及CKD的早期诊断可能会改善这些干预措施的应用和疗效，并为对抗慢性疾病中的肌肉萎缩和血管损伤提供新的线索。
Chronic kidney disease (CKD) shares many phenotypic similarities with other chronic diseases, including heart failure, chronic obstructive pulmonary disease, HIV infection and rheumatoid arthritis. The most apparent similarity is premature ageing, involving accelerated vascular disease and muscle wasting. We propose that in addition to a sedentary lifestyle and psychosocial and socioeconomic determinants, four major disease-induced mechanisms underlie premature ageing in CKD: an increase in allostatic load, activation of the 'stress resistance response', activation of age-promoting mechanisms and impairment of anti-ageing pathways. The most effective current interventions to modulate premature ageing-treatment of the underlying disease, optimal nutrition, correction of the internal environment and exercise training-reduce systemic inflammation and oxidative stress and induce muscle anabolism. Deeper mechanistic insight into the phenomena of premature ageing as well as early diagnosis of CKD might improve the application and efficacy of these interventions and provide novel leads to combat muscle wasting and vascular impairment in chronic diseases.