Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China.
Pediatr Nephrol. 2022 Dec;37(12):3009-3018. doi: 10.1007/s00467-022-05532-2. Epub 2022 Mar 26.
Acute kidney injury (AKI) is a common clinical complication characterized by a sudden deterioration of the kidney's excretory function, which normally occurs secondary to another serious illness. AKI is an important risk factor for chronic kidney disease (CKD) occurrence and progression to kidney failure. It is, therefore, crucial to block the development of AKI as early as possible. To date, existing animal studies have shown that senescence occurs in the early stage of AKI and is extremely critical to prognosis. Cellular senescence is an irreversible process of cell cycle arrest that is accompanied by alterations at the transcriptional, metabolic, and secretory levels along with modified cellular morphology and chromatin organization. Acute cellular senescence tends to play an active role, whereas chronic senescence plays a dominant role in the progression of AKI to CKD. The occurrence of chronic senescence is inseparable from senescence-associated secretory phenotype (SASP) and senescence-related pathways. SASP acts on normal cells to amplify the senescence signal through senescence-related pathways. Senescence can be improved by initiating reprogramming, which plays a crucial role in blocking the progression of AKI to CKD. This review integrates the existing studies on senescence in AKI from several aspects to find meaningful research directions to improve the prognosis of AKI and prevent the progression of CKD.
急性肾损伤（AKI）是一种常见的临床并发症，其特征为肾脏排泄功能的突然恶化，通常继发于其他严重疾病。AKI 是慢性肾脏病（CKD）发生和进展为肾衰竭的重要危险因素。因此，尽早阻断 AKI 的发展至关重要。迄今为止，现有的动物研究表明，衰老发生在 AKI 的早期阶段，对预后极为关键。细胞衰老是细胞周期停滞的不可逆过程，伴随着转录、代谢和分泌水平的改变，以及细胞形态和染色质组织的改变。急性细胞衰老往往起积极作用，而慢性衰老在 AKI 进展为 CKD 中起主导作用。慢性衰老的发生离不开衰老相关分泌表型（SASP）和衰老相关途径。SASP 通过衰老相关途径作用于正常细胞，放大衰老信号。通过启动重编程可以改善衰老，这在阻断 AKI 进展为 CKD 方面起着至关重要的作用。本综述从几个方面综合了现有的 AKI 衰老研究，以寻找有意义的研究方向，改善 AKI 的预后并预防 CKD 的进展。
