Division of Nephrology, Washington University in St. Louis, St. Louis, MO, USA.
Pediatr Nephrol. 2021 Oct;36(10):2997-3006. doi: 10.1007/s00467-020-04849-0. Epub 2021 Jan 7.
Our aging population is growing and developing treatments for age-related diseases such as Alzheimer's and Parkinson's disease has taken on an increasing urgency and is accompanied by high public awareness. The already high and rising incidence of acute kidney injury (AKI) in the elderly, however, has received relatively little attention despite the potentially fatal outcomes associated with an episode of AKI in this age group. When discussing AKI and aging, one should consider two aspects: first, elderly patients have an increased susceptibility to an AKI episode, and second, they have decreased kidney repair after AKI given the high incidence of progression to chronic kidney disease (CKD). It is unclear if the same factors that drive the increased susceptibility to AKI could be playing a role in the decreased repair capacity or if they are totally different and unrelated. This review will examine current knowledge on the risk factors for the increased susceptibility to AKI in the elderly and will also explore potential aspects that might contribute to a decreased kidney repair response in this age group.
我国的老龄化人口不断增加,针对与年龄相关的疾病(如阿尔茨海默病和帕金森病)的治疗也变得愈发紧迫,公众对此的认知度不断提高。然而,老年人急性肾损伤(AKI)的发病率已经很高且呈上升趋势,但与这一年龄组 AKI 发作相关的潜在致命后果相比,人们对其关注度相对较低。在讨论 AKI 和老龄化时,有两个方面需要考虑:首先,老年患者发生 AKI 的易感性增加,其次,他们在发生 AKI 后肾脏修复能力下降,因为 AKI 进展为慢性肾脏病(CKD)的发生率较高。目前尚不清楚导致 AKI 易感性增加的相同因素是否在肾脏修复能力下降中发挥作用,或者它们是否完全不同且不相关。本综述将探讨导致老年人 AKI 易感性增加的危险因素的现有知识,并探讨可能导致该年龄段肾脏修复反应下降的潜在因素。