Sharaf El Din Usama Abdel Azim, Salem Mona Mansour, Abdulazim Dina Ossama
Usama Abdel Azim Sharaf El Din, Departments of Nephrology, School of Medicine, Cairo University, Manial, Cairo 11759, Egypt.
World J Nephrol. 2016 May 6;5(3):258-73. doi: 10.5527/wjn.v5.i3.258.
Progression of chronic kidney disease (CKD) is inevitable. However, the last decade has witnessed tremendous achievements in this field. Today we are optimistic; the dream of withholding this progression is about to be realistic. The recent discoveries in the field of CKD management involved most of the individual diseases leading the patients to end-stage renal disease. Most of these advances involved patients suffering diabetic kidney disease, chronic glomerulonephritis, polycystic kidney disease, renal amyloidosis and chronic tubulointerstitial disease. The chronic systemic inflammatory status and increased oxidative stress were also investigated. This inflammatory status influences the anti-senescence Klotho gene expression. The role of Klotho in CKD progression together with its therapeutic value are explored. The role of gut as a major source of inflammation, the pathogenesis of intestinal mucosal barrier damage, the role of intestinal alkaline phosphatase and the dietary and therapeutic implications add a novel therapeutic tool to delay CKD progression.
慢性肾脏病(CKD)的进展是不可避免的。然而,过去十年在该领域取得了巨大成就。如今我们满怀希望;阻止这种进展的梦想即将成为现实。CKD管理领域的最新发现涉及导致患者发展至终末期肾病的大多数个体疾病。这些进展大多涉及患有糖尿病肾病、慢性肾小球肾炎、多囊肾病、肾淀粉样变性和慢性肾小管间质性疾病的患者。慢性全身性炎症状态和氧化应激增加也得到了研究。这种炎症状态会影响抗衰老的Klotho基因表达。探讨了Klotho在CKD进展中的作用及其治疗价值。肠道作为炎症的主要来源的作用、肠黏膜屏障损伤的发病机制、肠碱性磷酸酶的作用以及饮食和治疗意义为延缓CKD进展增添了一种新的治疗手段。