Multifactorial chronic kidney disease.

Jose Manuel Arreola Guerra, Jesus-Israel Martinez-Martinez
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Abstract

The burden of disease due to chronic kidney disease (CKD) has disproportionately grown in the last decades. This growth has not been similar in all regions. In the last few years, the results of clinical trials, particularly those evaluating sodium-glucose-cotransporter-2 (SGLT2) inhibitors and their efficacy in decreasing cardiovascular mortality and chronic kidney disease progression, revealed the relevance of a common protective pathway that remains non-specific as it has been detected in multiple clinical scenarios. However, the injury pathways in kidney disease are now well-defined in immunological, toxic, and genetic kidney pathologies. Therefore, the multifactoriality of chronic kidney disease is evident. Even prenatally, the number of nephrons is mostly determined by multiple factors that influence the maternal environment, and subsequently, throughout life, various exposures and pathologies gradually reduce the total number of nephrons. A better understanding of CKD as a multifactorial entity requires us to be aware of the primary injury pathways that can play a role throughout our lifetimes and implement more concrete measures to decrease the impact of CKD globally. Due to the heterogeneity of the CKD burden between world regions, local epidemiological studies are essential to understand the factors associated with CKD in each region.

多因素慢性肾脏疾病。
在过去的几十年里,慢性肾脏疾病(CKD)造成的疾病负担不成比例地增长。并非所有地区的增长都是相似的。在过去的几年里,临床试验的结果,特别是那些评估钠-葡萄糖-共转运蛋白-2 (SGLT2)抑制剂及其在降低心血管死亡率和慢性肾脏疾病进展方面的功效的结果,揭示了一种共同的保护途径的相关性,这种途径仍然是非特异性的,因为它已经在多种临床情况下被检测到。然而,肾脏疾病的损伤途径现在在免疫、毒性和遗传性肾脏病理中被明确定义。因此,慢性肾脏疾病的多因素性是显而易见的。即使在出生前,肾单位的数量也主要由影响母体环境的多种因素决定,随后,在整个生命过程中,各种暴露和病理逐渐减少肾单位的总数。为了更好地理解CKD是一个多因素的实体,我们需要意识到在我们的一生中可能发挥作用的主要损伤途径,并实施更具体的措施来减少全球CKD的影响。由于世界各地区CKD负担的异质性,当地流行病学研究对于了解各地区CKD相关因素至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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