Klahr S
Department of Internal Medicine, Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, Missouri 63100-1092, USA.
Intern Med. 2000 May;39(5):355-61. doi: 10.2169/internalmedicine.39.355.
Obstructive nephropathy is a relatively common entity that is treatable and often reversible. It occurs at all ages from infancy to elderly subjects. Obstructive uropathy is classified according to the degree, duration and site of the obstruction. It is the result of functional or anatomic lesions located in the urinary tract. The causes of obstructive uropathy are many. Obstruction of the urinary tract may decrease renal blood flow and the glomerular filtration rate. Several abnormalities in tubular function may occur in obstructive nephropathy. These include decreased reabsorption of solutes and water, inability to concentrate the urine and impaired excretion of hydrogen and potassium. Renal interstitial fibrosis is a common finding in patients with long-term obstructive uropathy. Several factors: macrophages, growth factors, hypoxia, cytokines are involved in the pathogenesis of interstitial fibrosis. It has been shown that ACE inhibitors ameliorate the interstitial fibrosis in animals with obstructive uropathy.
梗阻性肾病是一种相对常见的疾病,可治疗且通常可逆。它发生于从婴儿到老年的所有年龄段。梗阻性尿路病根据梗阻的程度、持续时间和部位进行分类。它是尿路中功能性或解剖性病变的结果。梗阻性尿路病的病因众多。尿路梗阻可能会降低肾血流量和肾小球滤过率。梗阻性肾病可能会出现几种肾小管功能异常。这些异常包括溶质和水的重吸收减少、尿液浓缩能力下降以及氢和钾排泄受损。肾间质纤维化是长期梗阻性尿路病患者的常见表现。巨噬细胞、生长因子、缺氧、细胞因子等多种因素参与了间质纤维化的发病机制。研究表明,血管紧张素转换酶抑制剂可改善梗阻性尿路病动物的间质纤维化。