Orr Sarah E, Bridges Christy C
Mercer University School of Medicine, Division of Basic Medical Sciences, 1550 College St., Macon, GA 31207, USA.
Int J Mol Sci. 2017 May 12;18(5):1039. doi: 10.3390/ijms18051039.
Chronic kidney disease (CKD) is a common progressive disease that is typically characterized by the permanent loss of functional nephrons. As injured nephrons become sclerotic and die, the remaining healthy nephrons undergo numerous structural, molecular, and functional changes in an attempt to compensate for the loss of diseased nephrons. These compensatory changes enable the kidney to maintain fluid and solute homeostasis until approximately 75% of nephrons are lost. As CKD continues to progress, glomerular filtration rate decreases, and remaining nephrons are unable to effectively eliminate metabolic wastes and environmental toxicants from the body. This inability may enhance mortality and/or morbidity of an individual. Environmental toxicants of particular concern are arsenic, cadmium, lead, and mercury. Since these metals are present throughout the environment and exposure to one or more of these metals is unavoidable, it is important that the way in which these metals are handled by target organs in normal and disease states is understood completely.
慢性肾脏病（CKD）是一种常见的进行性疾病，其典型特征是功能性肾单位永久性丧失。随着受损肾单位硬化并死亡，剩余的健康肾单位会发生许多结构、分子和功能上的变化，试图弥补患病肾单位的损失。这些代偿性变化使肾脏能够维持体液和溶质平衡，直到大约75%的肾单位丧失。随着CKD持续进展，肾小球滤过率下降，剩余的肾单位无法有效地从体内清除代谢废物和环境毒物。这种无能可能会增加个体的死亡率和/或发病率。特别值得关注的环境毒物是砷、镉、铅和汞。由于这些金属存在于整个环境中，接触其中一种或多种金属是不可避免的，因此全面了解这些金属在正常和疾病状态下被靶器官处理的方式非常重要。
