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代谢功能障碍相关肾病:发病机制与临床表现

Metabolic dysfunction-associated kidney disease: pathogenesis and clinical manifestations.

作者信息

Bansal Anip, Chonchol Michel

机构信息

Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

出版信息

Kidney Int. 2025 Aug;108(2):194-200. doi: 10.1016/j.kint.2025.01.044. Epub 2025 May 14.

Abstract

In recent years, there have been significant changes in the lifestyle and dietary habits of the population characterized by an increased intake of high-calorie food and a sedentary lifestyle without physical activity. The increased prevalence of overweight and obesity has led to metabolic dysfunction and related complications, such as cardiovascular disease and chronic kidney disease. The purpose of this review is to highlight the importance, clinical features, and pathogenesis of metabolic dysfunction-associated kidney disease (MDAKD). MDAKD is a term that describes kidney disease arising from metabolic dysfunction, often in the context of metabolic syndrome, and is characterized by the presence of chronic kidney disease in individuals with metabolic abnormalities such as obesity, insulin resistance, diabetes mellitus, dyslipidemia, and hypertension. MDAKD includes diabetic kidney disease, obesity-related kidney disease, and, increasingly, other less common kidney diseases where metabolic dysfunction may affect disease progression. MDAKD is part of a spectrum of diseases whose pathogenesis is driven by metabolic dysfunction and has recently led to the proposal of a new nomenclature including metabolic dysfunction-associated steatotic liver disease and cardio-kidney-metabolic syndrome. The new terminology of MDAKD places additional emphasis on the pathogenic role of metabolic dysfunction in kidney disease.

摘要

近年来,人群的生活方式和饮食习惯发生了显著变化,其特点是高热量食物摄入量增加,且生活方式久坐不动,缺乏体育活动。超重和肥胖患病率的上升导致了代谢功能障碍及相关并发症,如心血管疾病和慢性肾脏病。本综述的目的是强调代谢功能障碍相关肾病(MDAKD)的重要性、临床特征和发病机制。MDAKD是一个描述由代谢功能障碍引起的肾脏疾病的术语,通常发生在代谢综合征的背景下,其特征是在患有肥胖、胰岛素抵抗、糖尿病、血脂异常和高血压等代谢异常的个体中存在慢性肾脏病。MDAKD包括糖尿病肾病、肥胖相关肾病,以及越来越多的其他不太常见的肾脏疾病,其中代谢功能障碍可能影响疾病进展。MDAKD是一系列疾病的一部分,其发病机制由代谢功能障碍驱动,最近导致了一种新的命名法的提出,包括代谢功能障碍相关脂肪性肝病和心肾代谢综合征。MDAKD的新术语进一步强调了代谢功能障碍在肾脏疾病中的致病作用。

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