Palubiski Lisa M, O'Halloran Ken D, O'Neill Julie
Department of Physiology, School of Medicine, College of Medicine & Health, University College Cork, Cork, Ireland.
Front Physiol. 2020 Jul 16;11:756. doi: 10.3389/fphys.2020.00756. eCollection 2020.
Under normal physiological conditions, renal tissue oxygen is tightly regulated. At high altitude, a physiological challenge is imposed by the decrease in atmospheric oxygen. At the level of the kidney, the physiological adaptation to high altitude is poorly understood, which might relate to different integrated responses to hypoxia over different time domains of exposure. Thus, this systematic review sought to examine the renal physiological adaptation to high altitude in the context of the magnitude and duration of exposure to high altitude in the healthy kidney model. To conduct the review, three electronic databases were examined: OVID, PubMed, and Scopus. Search terms included: Altitude, renal, and kidney. The broad, but comprehensive search, retrieved 1,057 articles published between 1997 and April 2020. Fourteen studies were included in the review. The inconsistent effect of high altitude on renal hemodynamic parameters (glomerular filtration rate, renal blood flow, and renal plasma flow), electrolyte balance, and renal tissue oxygen is difficult to interpret; however, the data suggest that the nature and extent of renal physiological adaptation at high altitude appears to be related to the magnitude and duration of the exposure. It is clear that renal physiological adaptation to high altitude is a complex process that is not yet fully understood. Further research is needed to better understand the renal physiological adaptation to hypoxia and how renal oxygen homeostasis and metabolism is defended during exposure to high altitude and affected as a long-term consequence of renal adaptation at high altitude.
在正常生理条件下，肾组织氧受到严格调控。在高海拔地区，大气氧含量降低构成了一项生理挑战。在肾脏层面，对高海拔的生理适应机制尚不清楚，这可能与在不同暴露时域对缺氧的不同综合反应有关。因此，本系统综述旨在在健康肾脏模型中，研究高海拔暴露的程度和持续时间背景下的肾脏生理适应情况。为进行该综述，检索了三个电子数据库：OVID、PubMed和Scopus。检索词包括：海拔、肾脏、肾。经过广泛但全面的检索，共检索到1997年至2020年4月期间发表的1057篇文章。本综述纳入了14项研究。高海拔对肾脏血流动力学参数（肾小球滤过率、肾血流量和肾血浆流量）、电解质平衡和肾组织氧的影响不一致，难以解读；然而，数据表明，高海拔地区肾脏生理适应的性质和程度似乎与暴露的程度和持续时间有关。显然，肾脏对高海拔的生理适应是一个尚未完全理解的复杂过程。需要进一步研究，以更好地了解肾脏对缺氧的生理适应，以及在高海拔暴露期间肾脏氧稳态和代谢如何得到维持，以及作为高海拔肾脏适应的长期后果会受到怎样的影响。
