Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China.
Int J Mol Sci. 2021 Oct 19;22(20):11253. doi: 10.3390/ijms222011253.
Mitochondria are heterogeneous and highly dynamic organelles, playing critical roles in adenosine triphosphate (ATP) synthesis, metabolic modulation, reactive oxygen species (ROS) generation, and cell differentiation and death. Mitochondrial dysfunction has been recognized as a contributor in many diseases. The kidney is an organ enriched in mitochondria and with high energy demand in the human body. Recent studies have been focusing on how mitochondrial dysfunction contributes to the pathogenesis of different forms of kidney diseases, including acute kidney injury (AKI) and chronic kidney disease (CKD). AKI has been linked to an increased risk of developing CKD. AKI and CKD have a broad clinical syndrome and a substantial impact on morbidity and mortality, encompassing various etiologies and representing important challenges for global public health. Renal mitochondrial disorders are a common feature of diverse forms of AKI and CKD, which result from defects in mitochondrial structure, dynamics, and biogenesis as well as crosstalk of mitochondria with other organelles. Persistent dysregulation of mitochondrial homeostasis in AKI and CKD affects diverse cellular pathways, leading to an increase in renal microvascular loss, oxidative stress, apoptosis, and eventually renal failure. It is important to understand the cellular and molecular events that govern mitochondria functions and pathophysiology in AKI and CKD, which should facilitate the development of novel therapeutic strategies. This review provides an overview of the molecular insights of the mitochondria and the specific pathogenic mechanisms of mitochondrial dysfunction in the progression of AKI, CKD, and AKI to CKD transition. We also discuss the possible beneficial effects of mitochondrial-targeted therapeutic agents for the treatment of mitochondrial dysfunction-mediated AKI and CKD, which may translate into therapeutic options to ameliorate renal injury and delay the progression of these kidney diseases.
线粒体是异质性和高度动态的细胞器,在三磷酸腺苷 (ATP) 合成、代谢调节、活性氧 (ROS) 生成以及细胞分化和死亡中发挥关键作用。线粒体功能障碍已被认为是许多疾病的发病原因之一。肾脏是富含线粒体且人体对能量需求较高的器官。最近的研究集中在探讨线粒体功能障碍如何导致不同形式的肾脏疾病(包括急性肾损伤 (AKI) 和慢性肾脏病 (CKD))的发病机制。AKI 与 CKD 的发病风险增加有关。AKI 和 CKD 具有广泛的临床综合征,对发病率和死亡率有重大影响,涵盖各种病因,对全球公共卫生构成重要挑战。肾脏线粒体疾病是多种 AKI 和 CKD 的共同特征,其源于线粒体结构、动力学和生物发生的缺陷以及线粒体与其他细胞器的相互作用。AKI 和 CKD 中线粒体动态平衡的持续失调会影响多种细胞途径,导致肾微血管丢失、氧化应激、细胞凋亡增加,最终导致肾衰竭。了解 AKI 和 CKD 中线粒体功能和病理生理学的调控细胞和分子事件对于开发新的治疗策略非常重要。这篇综述概述了线粒体的分子见解以及 AKI、CKD 和 AKI 向 CKD 转变过程中线粒体功能障碍的特定发病机制。我们还讨论了靶向线粒体的治疗剂治疗线粒体功能障碍介导的 AKI 和 CKD 的可能有益效果,这可能转化为改善肾损伤和延缓这些肾脏疾病进展的治疗选择。
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