School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Ren Fail. 2023 Dec;45(1):2146512. doi: 10.1080/0886022X.2022.2146512.
Diabetic kidney disease (DKD) is a common complication of diabetes and has become the leading cause of end-stage kidney disease. The pathogenesis of DKD is complicated, and oxidative stress is considered as a core of DKD onset. High glucose can lead to increased production of reactive oxygen species (ROS) the polyol, PKC, AGE/RAGE and hexosamine pathways, resulting in enhanced oxidative stress response. In this way, pathways such as PI3K/Akt, TGF-β1/p38-MAPK and NF-κB are activated, inducing endothelial cell apoptosis, inflammation, autophagy and fibrosis that cause histologic and functional abnormalities of the kidney and finally result in kidney injury. Presently, the treatment for DKD remains an unresolved issue. Traditional Chinese medicine (TCM) has unique advantages for DKD prevention and treatment attributed to its multi-target, multi-component, and multi-pathway characteristics. Numerous studies have proved that Chinese herbs (e.g., Golden Thread, Kudzuvine Root, Tripterygium glycosides, and Ginseng) and patent medicines (e.g., Shenshuaining Tablet, Compound Rhizoma Coptidis Capsule, and Zishen Tongluo Granule) are effective for DKD treatment. The present review described the role of oxidative stress in DKD pathogenesis and the effect of TCM intervention for DKD prevention and treatment, in an attempt to provide evidence for clinical practice.
糖尿病肾病（DKD）是糖尿病的常见并发症，已成为终末期肾病的主要原因。DKD 的发病机制复杂，氧化应激被认为是 DKD 发病的核心。高血糖可导致活性氧（ROS）的产生增加、多元醇、蛋白激酶 C（PKC）、晚期糖基化终末产物（AGE）/受体（RAGE）和己糖胺途径，从而增强氧化应激反应。这样，PI3K/Akt、转化生长因子-β1/p38-MAPK 和 NF-κB 等途径被激活，诱导内皮细胞凋亡、炎症、自噬和纤维化，导致肾脏的组织学和功能异常，最终导致肾脏损伤。目前，DKD 的治疗仍然是一个未解决的问题。由于具有多靶点、多成分、多途径的特点，中医药在 DKD 的防治方面具有独特的优势。大量研究证明，中药（如金线莲、葛根、雷公藤多苷、人参）和专利药（如肾衰宁片、复方黄连胶囊、 滋肾通络颗粒）对 DKD 的治疗有效。本综述描述了氧化应激在 DKD 发病机制中的作用以及中医药干预 DKD 的防治作用，以期为临床实践提供证据。
