Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
Trends Mol Med. 2021 Sep;27(9):882-894. doi: 10.1016/j.molmed.2021.06.004. Epub 2021 Jun 25.
Renal artery stenosis (RAS) elicits the development of hypertension and post-stenotic kidney damage, which may become irresponsive to restoration of arterial patency. Rather than mere losses of blood flow or oxygen supply, irreversible intrarenal microvascular rarefaction, tubular injury, and interstitial fibrosis are now attributed to intrinsic pathways activated within the kidney, focusing attention on the kidney parenchyma as a therapeutic target. Several regenerative approaches involving the delivery of reparative cells or products have achieved kidney repair in experimental models of RAS and the delivery of mesenchymal stem/stromal cells (MSCs) has already been translated to human subjects with RAS with promising results. The ongoing development of innovative approaches in kidney disease awaits application, validation, and acceptance as routine clinical treatment to avert kidney damage in RAS.
肾动脉狭窄（RAS）可引发高血压和狭窄后肾脏损伤，而动脉再通可能对此类损伤无效。目前认为，导致肾内小血管稀疏、肾小管损伤和间质纤维化的并非单纯的血流或氧供损失，而是肾脏内固有途径的激活，这使得人们将注意力集中在肾脏实质作为治疗靶点上。几种涉及修复细胞或产物递送的再生方法已在 RAS 的实验模型中实现了肾脏修复，间充质干细胞（MSCs）的递送也已应用于 RAS 患者，取得了有前景的结果。创新性肾脏疾病治疗方法的不断发展，有待应用、验证和接受为常规临床治疗，以避免 RAS 中的肾脏损伤。
