Tubular atrophy in the pathogenesis of chronic kidney disease progression.
The longstanding focus in chronic kidney disease (CKD) research has been on the glomerulus, which is sensible because this is where glomerular filtration occurs, and a large proportion of progressive CKD is associated with significant glomerular pathology. However, it has been known for decades that...
| Publicado en: | Pediatric Nephrology Vol. 31; no. 5; pp. 693 - 707 |
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| Autor principal: | |
| Formato: | pictorial review statistics Journal Article |
| Publicado: |
Springer Nature
May2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=113970866&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 113970866 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: May2016 vid: 31 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 113970866 113970866 113970866 10.1007/s00467-015-3169-4 113970866 ppf: 693 ppct: 14 formats: fmt: @attributes: type: P tig: atl: Tubular atrophy in the pathogenesis of chronic kidney disease progression. aug: au: Schelling, Jeffrey sug: subj: Kidney Failure, Chronic Therapy Disease Progression Nephritis, Interstitial Pathology Epithelial Cells Physiopathology Child Apoptosis Oxidative Stress Child: 6-12 years ab: The longstanding focus in chronic kidney disease (CKD) research has been on the glomerulus, which is sensible because this is where glomerular filtration occurs, and a large proportion of progressive CKD is associated with significant glomerular pathology. However, it has been known for decades that tubular atrophy is also a hallmark of CKD and that it is superior to glomerular pathology as a predictor of glomerular filtration rate decline in CKD. Nevertheless, there are vastly fewer studies that investigate the causes of tubular atrophy, and fewer still that identify potential therapeutic targets. The purpose of this review is to discuss plausible mechanisms of tubular atrophy, including tubular epithelial cell apoptosis, cell senescence, peritubular capillary rarefaction and downstream tubule ischemia, oxidative stress, atubular glomeruli, epithelial-to-mesenchymal transition, interstitial inflammation, lipotoxicity and Na/H exchanger-1 inactivation. Once a a better understanding of tubular atrophy (and interstitial fibrosis) pathophysiology has been obtained, it might then be possible to consider tandem glomerular and tubular therapeutic strategies, in a manner similar to cancer chemotherapy regimens, which employ multiple drugs to simultaneously target different mechanistic pathways. pubtype: Academic Journal doctype: pictorial review statistics Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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