Simeoni Mariadelina, Damiano Sara, Capolongo Giovanna, Trepiccione Francesco, Zacchia Miriam, Fuiano Giorgio, Capasso Giovambattista
Department of Nephrology, Magna Graecia University Hospital, Catanzaro, Italy.
Department of Nephrology, University of Campania "Luigi Vanvitelli," Naples, Italy.
Kidney Dis (Basel). 2017 Jul;3(2):43-49. doi: 10.1159/000475841. Epub 2017 May 25.
The prevention and slowing of chronic kidney disease still represent major challenges in nephrology. To this end, a major contribution may come from the extensive knowledge on the molecular pathways involved in the pathogenesis of rare kidney diseases, since it is now possible to shed light on several aspects of these pathologies thanks to the introduction of new technologies, including next-generation sequencing.
In steroid-resistant nephrotic patients, a genetic background has been demonstrated in both children and adults; individualized mutations have been correlated with glomerular filtration barrier alterations. In addition, studies on genetic tubulopathies expressing hypertensive phenotypes can provide useful information for a correct diagnostic and therapeutic approach in patients with essential hypertension and a poor responsiveness to therapy.
This review deals with the pathogenesis of rare glomerular diseases and tubulopathies associated with hypertension, highlighting the importance of the study of rare diseases to better understand the molecular basis of more common and complex disorders leading to end-stage renal disease.
慢性肾脏病的预防和病情延缓仍是肾脏病学领域的重大挑战。为此,对罕见肾脏病发病机制中涉及的分子途径的广泛了解可能会做出重大贡献,因为借助包括新一代测序在内的新技术,现在有可能阐明这些疾病的多个方面。
在激素抵抗型肾病患者中,儿童和成人都已证实存在遗传背景;个别突变与肾小球滤过屏障改变相关。此外,对表现为高血压表型的遗传性肾小管疾病的研究可为原发性高血压且治疗反应不佳的患者提供正确诊断和治疗方法的有用信息。
本综述探讨了与高血压相关的罕见肾小球疾病和肾小管疾病的发病机制,强调了研究罕见病对于更好地理解导致终末期肾病的更常见和复杂疾病的分子基础的重要性。