Division of Nephrology and Hypertension and Division of Epidemiology, Rochester, MN 55905, USA. rule.andrew @ mayo.edu
Nephron Physiol. 2011;119 Suppl 1(Suppl 1):p6-11. doi: 10.1159/000328012. Epub 2011 Aug 10.
Nephrosclerosis can be defined by the presence of glomerulosclerosis, tubular atrophy, interstitial fibrosis, and arteriosclerosis on renal biopsy. Chronic kidney disease is identified clinically by a reduction in glomerular filtration rate (GFR) and has been characterized histologically by nephrosclerosis. Many relatively healthy older adults have been diagnosed with chronic kidney disease because of a decline in GFR with normal aging. Recent data show that in healthy adults (living kidney donors), nephrosclerosis on renal biopsy does not associate with GFR independent of age. This may be explained by the decline in GFR and nephrosclerosis being universal with aging (i.e. senescence), by structural changes in the kidney other than nephrosclerosis impacting GFR, or by extrarenal factors affecting GFR decline with age. However, the argument that the age-related decline in GFR can be fully explained by the development of nephrosclerosis in a subset of older adults is not supported by existing data.
肾硬化症可以通过肾活检中的肾小球硬化、肾小管萎缩、间质纤维化和动脉硬化来定义。慢性肾脏病在临床上通过肾小球滤过率 (GFR) 的降低来识别，并且已经通过肾硬化症的组织学特征来描述。许多相对健康的老年人被诊断患有慢性肾脏病，因为 GFR 在正常衰老过程中下降。最近的数据表明，在健康成年人（活体供肾者）中，肾活检中的肾硬化症与 GFR 无关，与年龄无关。这可能是由于 GFR 和肾硬化症的下降是普遍存在的（即衰老），除了肾硬化症之外，肾脏的结构变化影响 GFR，或者是由于肾脏以外的因素影响 GFR 随年龄的下降。然而，现有的数据并不支持这样一种观点，即 GFR 的年龄相关性下降可以完全由老年人群中一部分人的肾硬化症的发展来解释。
