Blantz Roland C, Singh Prabhleen
Division of Nephrology-Hypertension, University of California San Diego and Veterans Affairs San Diego Healthcare System, San Diego, CA.
Adv Chronic Kidney Dis. 2014 May;21(3):297-303. doi: 10.1053/j.ackd.2014.03.006.
Diabetes mellitus with its attendant complications is a significant cause of morbidity and mortality with diabetic nephropathy being the leading cause of end stage renal disease in the Western world. Characteristic structural and functional changes in the kidney early in the course of diabetes have been shown to have enduring effects on the progression of disease. A better understanding of the mechanisms underlying these changes is imperative to the development of new therapeutic strategies. Renal hypertrophy and hyperfiltration along with proximal tubular hyperreabsorption are among the distinctive features of early diabetic nephropathy. Additionally, there are particular alterations in the sensitivity of the glomerular and tubular function to dietary salt intake in early diabetes. Herein, we focus on these early physiologic changes and discuss some of the primary and secondary mechanisms discovered in recent years which lead to these alterations in kidney function.
糖尿病及其伴随的并发症是发病和死亡的重要原因，在西方世界，糖尿病肾病是终末期肾病的主要原因。糖尿病病程早期肾脏特征性的结构和功能变化已被证明对疾病进展有持久影响。更好地理解这些变化背后的机制对于开发新的治疗策略至关重要。肾肥大、超滤以及近端肾小管重吸收增加是早期糖尿病肾病的显著特征。此外，早期糖尿病患者肾小球和肾小管功能对饮食中盐摄入的敏感性存在特殊改变。在此，我们重点关注这些早期生理变化，并讨论近年来发现的导致肾功能改变的一些主要和次要机制。
