Pena-Polanco Julio E, Fried Linda F
Department of Medicine, Renal-Electrolyte Division, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Renal Section, VA Pittsburgh Healthcare System, Pittsburgh, PA; Epidemiology and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA.
Semin Nephrol. 2016 Jul;36(4):331-42. doi: 10.1016/j.semnephrol.2016.05.009.
Chronic kidney disease (CKD) is a common condition that has become a significant public health concern. The mainstay therapeutic approach to CKD is based on renin-angiotensin system blockade as well as blood pressure and glycemic control. Despite these interventions, the management of CKD remains suboptimal, with a large proportion of the CKD population progressing to end-stage renal disease. Newer strategies for the treatment of CKD have emerged over the past years focusing on decreasing inflammation and delaying the development of fibrosis. Despite promising results in experimental models and small randomized studies, adequately powered randomized trials are required to evaluate the benefits and risks of these therapies in the CKD population. In this review, we discuss the evidence behind, and gaps in our knowledge of, established therapies as well as newer potential strategies for managing CKD, concentrating on interventions that currently are being evaluated in randomized studies.
慢性肾脏病（CKD）是一种常见疾病，已成为重大的公共卫生问题。CKD的主要治疗方法基于肾素-血管紧张素系统阻断以及血压和血糖控制。尽管采取了这些干预措施，但CKD的管理仍不尽人意，很大一部分CKD患者会进展为终末期肾病。在过去几年中，出现了治疗CKD的新策略，重点是减轻炎症和延缓纤维化的发展。尽管在实验模型和小型随机研究中取得了令人鼓舞的结果，但仍需要有足够样本量的随机试验来评估这些疗法在CKD人群中的益处和风险。在本综述中，我们讨论了既定疗法背后的证据以及我们在这方面知识的差距，以及管理CKD的新潜在策略，重点关注目前正在随机研究中评估的干预措施。
