Boon Ai-Ching, Bulmer Andrew C, Coombes Jeff S, Fassett Robert G
Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Gold Coast, Australia; and.
Heart Foundation Research Centre, Griffith Health Institute, Griffith University, Gold Coast, Australia; and
Am J Physiol Renal Physiol. 2014 Jul 15;307(2):F123-36. doi: 10.1152/ajprenal.00039.2014. Epub 2014 Apr 23.
Unconjugated bilirubin is an endogenous circulating antioxidant, bound to albumin, and therefore is retained in the vascular compartment. Bilirubin has well-documented neurotoxic effects in infants; however, current evidence indicates mildly elevated bilirubin is associated with protection from cardiovascular disease and all-cause mortality in adults. Recent clinical studies show mildly elevated bilirubin is associated with protection from kidney damage and dysfunction, in addition to cardiovascular events and all-cause mortality in patients undergoing hemodialysis. This is the first review to examine the clinical evidence and summarize the potential mechanisms of action that link bilirubin to protection from kidney damage, subsequent kidney failure, and dialysis-related mortality. With this understanding, it is hoped that new therapies will be developed to prevent renal dysfunction and mortality from cardiovascular disease in at-risk individuals.
未结合胆红素是一种内源性循环抗氧化剂，与白蛋白结合，因此保留在血管腔内。胆红素对婴儿具有公认的神经毒性作用；然而，目前的证据表明，轻度升高的胆红素与成年人预防心血管疾病和全因死亡率有关。最近的临床研究表明，除了接受血液透析患者的心血管事件和全因死亡率外，轻度升高的胆红素还与预防肾损伤和功能障碍有关。这是第一篇审查临床证据并总结将胆红素与预防肾损伤、后续肾衰竭及透析相关死亡率联系起来的潜在作用机制的综述。基于这一认识，希望能开发出新的疗法，以预防高危个体的肾功能障碍和心血管疾病导致的死亡。
