Department of Medicine, Division of Nephrology, Cathay General Hospital, School of Medicine, Fu-Jen Catholic University, Taipei 106, Taiwan.
National Defense Medical Center, Graduate Institute of Medical Sciences, Taipei 114, Taiwan.
Int J Mol Sci. 2021 Sep 18;22(18):10084. doi: 10.3390/ijms221810084.
Chronic kidney disease (CKD), defined as the presence of irreversible structural or functional kidney damages, increases the risk of poor outcomes due to its association with multiple complications, including altered mineral metabolism, anemia, metabolic acidosis, and increased cardiovascular events. The mainstay of treatments for CKD lies in the prevention of the development and progression of CKD as well as its complications. Due to the heterogeneous origins and the uncertainty in the pathogenesis of CKD, efficacious therapies for CKD remain challenging. In this review, we focus on the following four themes: first, a summary of the known factors that contribute to CKD development and progression, with an emphasis on avoiding acute kidney injury (AKI); second, an etiology-based treatment strategy for retarding CKD, including the approaches for the common and under-recognized ones; and third, the recommended approaches for ameliorating CKD complications, and the final section discusses the novel agents for counteracting CKD progression.
慢性肾脏病(CKD)定义为存在不可逆转的结构性或功能性肾脏损伤,由于其与多种并发症相关,包括矿物质代谢改变、贫血、代谢性酸中毒和心血管事件增加,增加了不良结局的风险。CKD 的治疗主要在于预防 CKD 的发生和进展及其并发症。由于 CKD 的起源具有异质性,发病机制尚不确定,因此针对 CKD 的有效治疗方法仍然具有挑战性。在这篇综述中,我们重点关注以下四个主题:首先,总结已知的导致 CKD 发生和进展的因素,重点是避免急性肾损伤(AKI);其次,基于病因的延缓 CKD 的治疗策略,包括常见和认识不足的方法;第三,改善 CKD 并发症的推荐方法,最后一节讨论了对抗 CKD 进展的新型药物。