Ma Ke, Zheng Zi-Run, Meng Yu
The First Affiliated Hospital of Jinan University, Guangzhou 510000, China.
Central Laboratory, The Fifth Affiliated Hospital of Jinan University, Heyuan 517000, China.
J Clin Med. 2023 Feb 12;12(4):1459. doi: 10.3390/jcm12041459.
Chronic kidney disease (CKD) is a clinical syndrome secondary to the definitive change in function and structure of the kidney, which is characterized by its irreversibility and slow and progressive evolution. Alzheimer's disease (AD) is characterized by the extracellular accumulation of misfolded β-amyloid (Aβ) proteins into senile plaques and the formation of neurofibrillary tangles (NFTs) containing hyperphosphorylated tau. In the aging population, CKD and AD are growing problems. CKD patients are prone to cognitive decline and AD. However, the connection between CKD and AD is still unclear. In this review, we take the lead in showing that the development of the pathophysiology of CKD may also cause or exacerbate AD, especially the renin-angiotensin system (RAS). In vivo studies had already shown that the increased expression of angiotensin-converting enzyme (ACE) produces a positive effect in aggravating AD, but ACE inhibitors (ACEIs) have protective effects against AD. Among the possible association of risk factors in CKD and AD, we mainly discuss the RAS in the systemic circulation and the brain.
慢性肾脏病（CKD）是一种继发于肾脏功能和结构明确改变的临床综合征，其特点是具有不可逆性以及缓慢渐进性发展。阿尔茨海默病（AD）的特征是错误折叠的β-淀粉样蛋白（Aβ）在细胞外聚积形成老年斑，以及形成含有过度磷酸化tau蛋白的神经原纤维缠结（NFTs）。在老年人群体中，CKD和AD问题日益严重。CKD患者容易出现认知功能下降和AD。然而，CKD与AD之间的联系仍不明确。在本综述中，我们率先表明CKD病理生理学的发展可能也会导致或加重AD，尤其是肾素-血管紧张素系统（RAS）。体内研究已经表明血管紧张素转换酶（ACE）表达增加在加重AD方面产生了积极作用，但血管紧张素转换酶抑制剂（ACEIs）对AD具有保护作用。在CKD和AD可能相关的危险因素中，我们主要讨论体循环和大脑中的RAS。
