Department of Nephrology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University and Charlie Norwood VA Medical Center, Augusta, Georgia, USA.
Kidney Int. 2017 Nov;92(5):1071-1083. doi: 10.1016/j.kint.2017.06.030. Epub 2017 Sep 8.
Acute kidney injury (AKI) and chronic kidney disease (CKD) are interconnected. Although AKI-to-CKD transition has been intensively studied, the information of AKI on CKD is very limited. Nonetheless, AKI, when occurring in patients with CKD, is known to be more severe and difficult to recover. CKD is associated with significant changes in cell signaling in kidney tissues, including the activation of transforming growth factor-β, p53, hypoxia-inducible factor, and major developmental pathways. At the cellular level, CKD is characterized by mitochondrial dysfunction, oxidative stress, and aberrant autophagy. At the tissue level, CKD is characterized by chronic inflammation and vascular dysfunction. These pathologic changes may contribute to the heightened sensitivity of, and nonrecovery from, AKI in patients with CKD.
急性肾损伤 (AKI) 和慢性肾脏病 (CKD) 相互关联。虽然 AKI 向 CKD 的转变已得到深入研究，但有关 CKD 中 AKI 的信息却非常有限。尽管如此，当 CKD 患者发生 AKI 时，其病情通常更为严重且难以恢复。CKD 与肾脏组织中细胞信号的显著变化相关，包括转化生长因子-β、p53、缺氧诱导因子和主要发育途径的激活。在细胞水平上，CKD 的特征是线粒体功能障碍、氧化应激和异常自噬。在组织水平上，CKD 的特征是慢性炎症和血管功能障碍。这些病理变化可能导致 CKD 患者 AKI 的敏感性增加和无法恢复。
