Division of Endocrinology SUNY Downstate Medical Center, Brooklyn, NY 11203, United States.
Maturitas. 2012 Feb;71(2):94-103. doi: 10.1016/j.maturitas.2011.11.009. Epub 2011 Dec 3.
Chronic kidney disease has a significant worldwide prevalence affecting 7.2% of the global adult population with the number dramatically increasing in the elderly. Although the causes are various, diabetes is the most common cause of CKD in the United States and an increasing cause of the same worldwide. Therefore, we chose to focus on diabetic chronic kidney disease in this review. The pathogenesis is multifactorial involving adaptive hyperfiltration, advanced glycosylated end-product synthesis (AGES), prorenin, cytokines, nephrin expression and impaired podocyte-specific insulin signaling. Treatments focus on lifestyle interventions including control of hyperglycemia, hypertension and hyperlipidemia as well treatment of complications and preparation for renal replacement therapy. This review examines the current literature on the epidemiology, pathogenesis, complications and treatment of CKD as well as possible areas of future disease intervention.
慢性肾脏病在全球范围内具有较高的发病率，影响着全球 7.2%的成年人口，且在老年人群中发病率显著增加。尽管病因多种多样，但在美国，糖尿病是导致 CKD 的最常见病因，且在全球范围内也是导致 CKD 的一个日益重要的病因。因此，在本次综述中，我们选择专注于糖尿病性慢性肾脏病。其发病机制涉及多种因素，包括适应性超滤、晚期糖基化终产物合成（AGES）、前肾素、细胞因子、nephrin 表达和足细胞特异性胰岛素信号受损。治疗侧重于生活方式干预，包括控制高血糖、高血压和高血脂，以及治疗并发症和为肾脏替代治疗做准备。本综述探讨了 CKD 的流行病学、发病机制、并发症和治疗方面的最新文献，以及未来疾病干预的可能领域。
