Silver Samuel A, Gerarduzzi Casimiro
Division of Nephrology, Kingston Health Sciences Center, Queen's University, Kingston, ON, Canada.
Division de Néphrologie, Centre de recherche de l'Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada.
Can J Kidney Health Dis. 2019 Aug 16;6:2054358119868740. doi: 10.1177/2054358119868740. eCollection 2019.
The current review will discuss on the progress of studying the transition phase between acute kidney injury (AKI) and chronic kidney disease (CKD) through improved animal models, common AKI and CKD pathways, and how human studies may inform different translational approaches.
PubMed and Google Scholar.
A narrative review was performed using the main terms "acute kidney injury," "chronic kidney disease," "end-stage renal disease," "animal models," "review," "decision-making," and "translational research."
The last decade has shown much progress in the study of AKI, including evidence of a pathophysiological link between AKI and CKD. We are now in a phase of redesigning animal models and discovering mechanisms that can replicate the pathological conditions of the AKI-to-CKD continuum. Translating these findings into the clinic is a barrier that must be overcome. To this end, current efforts include prediction of AKI onset and maladaptive repair, detecting patients susceptible to the progression of chronic maladaptive repair, and understanding shared signaling mechanisms between AKI and CKD.
This is a narrative review of the literature that is partially influenced by the knowledge, perspectives, and experiences of the authors and their research background.
Overall, this new knowledge from the AKI-to-CKD continuum will help bridge the discontinuity that exists between animal models and patients, resulting in more effective translational biomarkers and therapeutics to test in known AKI pathologies thereby preventing the chronicity of kidney injury progression.
本综述将探讨通过改进动物模型、急性肾损伤(AKI)和慢性肾脏病(CKD)的常见途径来研究AKI与CKD过渡阶段的进展,以及人体研究如何为不同的转化方法提供信息。
PubMed和谷歌学术。
采用“急性肾损伤”“慢性肾脏病”“终末期肾病”“动物模型”“综述”“决策”和“转化研究”等主要术语进行叙述性综述。
过去十年在AKI研究方面取得了很大进展,包括有证据表明AKI与CKD之间存在病理生理联系。我们目前正处于重新设计动物模型并发现能够复制AKI至CKD连续过程病理状况的机制的阶段。将这些发现转化到临床是必须克服的障碍。为此,目前的努力包括预测AKI的发作和适应性不良修复、检测易发生慢性适应性不良修复进展的患者,以及了解AKI和CKD之间共享的信号传导机制。
这是一篇对文献进行的叙述性综述,部分受到作者的知识、观点、经验及其研究背景的影响。
总体而言,来自AKI至CKD连续过程的这一新知识将有助于弥合动物模型与患者之间存在的脱节,从而产生更有效的转化生物标志物和疗法,用于在已知的AKI病理中进行测试,进而预防肾损伤进展的慢性化。