Harris Raymond C, Neilson Eric G
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, USA.
Annu Rev Med. 2006;57:365-80. doi: 10.1146/annurev.med.57.121304.131342.
Various disciplines within nephrology investigate the mechanisms by which kidneys fail. Progress in the areas of glomerular hemodynamics, proteinuria, tubular biology, interstitial nephritis, fibroblast formation, and fibrosis have added kernels of information that together support a unified theory of renal progression. Prevention of progression to end-stage disease has largely focused on control of systemic and glomerular hypertension. Current success in delaying a decline in glomerular filtration rate underlines the promise of a more comprehensive approach. New knowledge about the cell biology of progression also suggests that other adjunctive therapies may be possible. We describe the progress and highlight those spheres where new-targeted interventions may arise.
肾脏病学的各个学科都在研究肾脏衰竭的机制。肾小球血流动力学、蛋白尿、肾小管生物学、间质性肾炎、成纤维细胞形成和纤维化等领域的进展提供了一些信息要点，共同支持了一个关于肾脏病变进展的统一理论。预防疾病进展至终末期主要集中在控制全身性和肾小球性高血压。目前在延缓肾小球滤过率下降方面取得的成功凸显了采用更全面方法的前景。关于病变进展的细胞生物学的新知识也表明可能有其他辅助治疗方法。我们描述了这方面的进展，并着重指出可能出现新的靶向干预措施的领域。
