Chen Yi, Kanwar Yashpal S, Chen Xueqin, Zhan Ming
School of Medicine, Ningbo University, Ningbo, 315000, China.
Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, 60611, US.
Curr Med Chem. 2024;31(6):697-725. doi: 10.2174/0929867330666230621112215.
Diabetic kidney disease (DKD) is one of the leading causes of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide. With the overpowering trend of aging, the prevalence of DKD in the elderly is progressively increasing. Genetic factors, abnormal glucose metabolism, inflammation, mitochondrial dysregulation, and oxidative stress all contribute to the development of DKD. Conceivably, during aging, these pathobiological processes are likely to be intensified, and this would further exacerbate the deterioration of renal functions in elderly patients, ultimately leading to ESRD. Currently, the pathogenesis of DKD in the elderly is not very well-understood. This study describes an appraisal of the relationship between diabetic nephropathy and aging while discussing the structural and functional changes in the aged kidney, the impact of related mechanisms on the outcome of DKD, and the latest advances in targeted therapies.
糖尿病肾病（DKD）是全球慢性肾脏病（CKD）和终末期肾病（ESRD）的主要病因之一。随着老龄化趋势加剧，老年人群中DKD的患病率正在逐步上升。遗传因素、糖代谢异常、炎症、线粒体调节异常以及氧化应激均促使DKD的发生发展。可以想象，在衰老过程中，这些病理生物学过程可能会加剧，进而进一步加速老年患者肾功能的恶化，最终导致ESRD。目前，老年DKD的发病机制尚不完全清楚。本研究阐述了对糖尿病肾病与衰老之间关系的评估，同时讨论了老年肾脏的结构和功能变化、相关机制对DKD预后的影响以及靶向治疗的最新进展。
