College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
Division of Nephrology, Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Front Endocrinol (Lausanne). 2023 Jan 16;13:1095211. doi: 10.3389/fendo.2022.1095211. eCollection 2022.
Chronic kidney disease (CKD) causes considerable morbidity, mortality, and health expenditures worldwide. Obesity is a significant risk factor for CKD development, partially explained by the high prevalence of diabetes mellitus and hypertension in obese patients. However, adipocytes also possess potent endocrine functions, secreting a myriad of cytokines and adipokines that contribute to insulin resistance and induce a chronic low-grade inflammatory state thereby damaging the kidney. CKD development itself is associated with various metabolic alterations that exacerbate adipose tissue dysfunction and insulin resistance. This adipose-renal axis is a major focus of current research, given the rising incidence of CKD and obesity. Cellular senescence is a biologic hallmark of aging, and age is another significant risk factor for obesity and CKD. An elevated senescent cell burden in adipose tissue predicts renal dysfunction in animal models, and senotherapies may alleviate these phenotypes. In this review, we discuss the direct mechanisms by which adipose tissue contributes to CKD development, emphasizing the potential clinical importance of such pathways in augmenting the care of CKD.
慢性肾脏病（CKD）在全球范围内导致相当大的发病率、死亡率和医疗支出。肥胖是 CKD 发展的一个重要危险因素，部分原因是肥胖患者中糖尿病和高血压的高发率。然而，脂肪细胞也具有强大的内分泌功能，分泌大量细胞因子和脂肪因子，导致胰岛素抵抗，并引发慢性低度炎症状态，从而损害肾脏。CKD 的发展本身与各种代谢改变有关，这些改变会加剧脂肪组织功能障碍和胰岛素抵抗。鉴于 CKD 和肥胖的发病率不断上升，这个脂肪-肾脏轴是当前研究的一个主要焦点。细胞衰老（cellular senescence）是衰老的生物学标志，年龄也是肥胖和 CKD 的另一个重要危险因素。脂肪组织中衰老细胞负担的增加预示着动物模型的肾功能障碍，而衰老治疗可能缓解这些表型。在这篇综述中，我们讨论了脂肪组织促进 CKD 发展的直接机制，强调了这些途径在增强 CKD 护理方面的潜在临床重要性。
