肾性贫血发生机制的研究现状
Research Status of the Mechanism of Renal Anemia
DOI: 10.12677/ACM.2021.115324, PDF,  被引量   
作者: 张 倩:青海大学研究生院,青海 西宁;巴应贵*:青海大学附属医院肾内科,青海 西宁
关键词: 肾性贫血发病机制慢性肾脏病Renal Anemia Pathogenesis Chronic Kidney Disease
摘要: 贫血是慢性肾脏病(Chronic Kidney Disease, CKD)常见的并发症之一,由于各种原因导致的肾功能损害引起的红系生长因子,即促红细胞生成素(Erythropoietin, EPO)的缺乏是最主要的原因,当然还有一些毒性物质的蓄积也参与了贫血的发生。贫血的发生显著提高了患者的就诊次数及住院率,心血管事件的发生率和死亡率。有研究显示,目前在我国,有1.2亿人患有慢性肾脏疾病,预计可能还会增加。相应地贫血的发生率也会随之增加。目前对于肾性贫血治疗的达标率还不理想,因此,明确肾性贫血的机制有助于为肾性贫血的治疗提供思路。本文就肾性贫血发病机制作一综述。
Abstract: Anemia is one of the common complications of Chronic Kidney Disease (CKD). The lack of erythropoietin (EPO) caused by renal damage caused by various reasons is the main reason for this anemia. The occurrence of anemia significantly increases the number of visits and hospitalizations, the incidence and mortality of cardiovascular events. Studies have shown that there are 120 million people suffering from chronic kidney disease in my country, and it is expected to increase. Correspondingly, the incidence of anemia will also increase. At present, the rate of reaching the standard for the treatment of renal anemia is not ideal. Therefore, clarifying the mechanism of renal anemia helps to provide ideas for the treatment of renal anemia. This article summarizes the pathogenesis of renal anemia.
文章引用:张倩, 巴应贵. 肾性贫血发生机制的研究现状[J]. 临床医学进展, 2021, 11(5): 2251-2256. https://doi.org/10.12677/ACM.2021.115324

参考文献

[1] Cernaro, V., et al. (2019) Erythropoiesis and Chronic Kidney Disease-Related Anemia: From Physiology to New Therapeutic Advancements. Medicinal Research Reviews, 39, 427-460.
[2] 李青. 肾性贫血的机制和治疗研究现状[D]: [硕士学位论文]. 南昌: 南昌大学, 2017.
[3] Fisher, J.W. (2003) Erythropoietin: Physiology and Pharmacology Update. Experimental Biology and Medicine, 228, 1-14. [Google Scholar] [CrossRef] [PubMed]
[4] 刘颖, 林洪丽. 慢性肾脏病贫血与炎症[J]. 中国实用内科杂志, 2020, 40(11): 908-911.
[5] Mihai, S., Codrici, E., Popescu, I.D., et al. (2018) Inflammation Related Mechanisms in Chronic Kidney Disease Prediction, Progression, and Outcome. Journal of Immunology Research, 2018, Article ID: 2180373. [Google Scholar] [CrossRef] [PubMed]
[6] 赵璐, 刘虹. 慢性肾脏病患者的炎症状态及其对肾性贫血治疗的影响[J]. 中国血液净化, 2020, 19(3): 149-152.
[7] Eustace, J.A., Astor, B., Muntner, P.M., et al. (2004) Prevalence of Acidosis and Inflammation and Their Association with Low Serum Albumin in Chronic Kidney Disease. Kidney International, 65, 1031-1040. [Google Scholar] [CrossRef] [PubMed]
[8] Sproston, N.R. and Ashworth, J.J. (2018) Role of C-Reactive Protein at Sites of Inflammation and Infection. Frontiers in Immunology, 9, 754. [Google Scholar] [CrossRef] [PubMed]
[9] Hom, J., Dulmovits, B.M., Mohandas, N., et al. (2015) The Erythroblastic Island as an Emerging Paradigm in the Anemia of Inflammation. Immunologic Research, 63, 75-89. [Google Scholar] [CrossRef] [PubMed]
[10] Dinkla, S., Vaneijk, L.T., Fuchs, B., et al. (2016) Inflammation-Associated Changes in Lipid Composition and the Organization of the Erythrocyte Membrane. BBA Clinical, 5, 186-192. [Google Scholar] [CrossRef] [PubMed]
[11] Karaboyas, A., Morgenstern, H., Fleischer, N.L., et al. (2020) Inflammation and Erythropoiesis-Stimulating Agent Response in Hemodialysis Patients: A Self-Matched Longitudinal Study of Anemia Management in the Dialysis Outcomes and Practice Patterns Study (DOPPS). Kidney Medicine, 2, 286-296. [Google Scholar] [CrossRef] [PubMed]
[12] Kimachi, M., Fukuma, S., Yamazaki, S., et al. (2015) Minor Elevation in C-Reactive Protein Levels Predicts Incidence of Erythropoiesis-Stimulating Agent Hyporesponsiveness among Hemodialysis Patients. Nephron, 131, 123-130. [Google Scholar] [CrossRef] [PubMed]
[13] Mccullough, K. and Bolisetty, S. (2020) Ferritins in Kidney Disease. Seminars in Nephrology, 40, 160-172. [Google Scholar] [CrossRef] [PubMed]
[14] Ueda, N. and Takasawa, K. (2018) Impact of Inflammation on Ferritin, Hepcidin and the Management of Iron Deficiency Anemia in Chronic Kidney Disease. Nutrients, 10, 1173. [Google Scholar] [CrossRef] [PubMed]
[15] Kim, Y.L., Kim, H., Kwon, Y.E., et al. (2016) Association between Vitamin D Deficiency and Anemia in Patients with End-Stage Renal Disease: A Cross-Sectional Study. Yonsei Medical Journal, 57, 1159-1164. [Google Scholar] [CrossRef] [PubMed]
[16] 朱丽娇, 徐承云, 刘欣, 等. 慢性肾脏病患者甲状旁腺激素与肾性贫血的关系[J]. 广东医学, 2018, 39(14): 2232-2235.
[17] 肖宇, 王洁. 肾性贫血发生机制的研究进展[J]. 广西医学, 2020, 42(2): 198-202.
[18] Yin, K. and Agrawal, D.K. (2014) Vitamin D and Inflammatory Diseases. Inflammation Research, 7, 69-87. [Google Scholar] [CrossRef
[19] 张燕丽, 卜玲芝, 敬小青. 儿童维生素D水平与脓毒症的相关性[J]. 世界最新医学信息文摘, 2019, 19(20): 38-39.
[20] 刘烨歆, 刘虹. 慢性肾脏病患者维生素D缺乏与贫血的关系[J]. 中国血液净化, 2016(11): 620-623.
[21] Smith, E.M., Alvarez, J.A., Kearns, M.D., et al. (2017) High-Dose Vitamin D3 Reduces Circulating Hepcidin Concentrations: A Pilot, Randomized, Double-Blind, Placebo-Controlled Trial in Healthy Adults. Clinical Nutrition, 36, 980-985. [Google Scholar] [CrossRef] [PubMed]
[22] Panwar, B., McCann, D., Olbina, G., et al. (2018) Effect of Calcitriol on Serum Hepcidin in Individuals with Chronic Kidney Disease: A Randomized Controlled Trial. BMC Nephrology, 19, 35. [Google Scholar] [CrossRef] [PubMed]
[23] Daryadel, A., Bettoni, C., Haider, T., et al. (2018) Erythropoietin Stimulates Fibroblast Growth Factor 23 (FGF23) in Mice and Men. Pflügers Archiv, 470, 1569-1582. [Google Scholar] [CrossRef] [PubMed]
[24] Agoro, R., Montagna, A., Goetz, R., et al. (2018) Inhibition of Fibro-Blast Growth Factor 23 (FGF23) Signaling Rescues Renal Anemia. FASEB Journal, 32, 3752-3764. [Google Scholar] [CrossRef
[25] 沈英, 张萍, 蒋华, 等. 甲状旁腺切除对尿毒症继发甲状旁腺功能亢进患者贫血和心功能的影响[J]. 中华肾脏病杂志, 2018, 34(5): 321-326.
[26] Cueff, A., Seear, R., Dyrda, A., Bouyer, G., Egee, S., Esposito, A., et al. (2010) Effects of Elevated Intracellular Calcium on the Osmotic Fragility of Human Red Blood Cells. Cell Calcium, 47, 29-36. [Google Scholar] [CrossRef] [PubMed]
[27] 毛永辉, 赵班, 陈欢, 等. 腹膜透析患者血清N末端前体脑钠肽水平的变化及影响因素探讨[J]. 中国血液净化, 2014, 13(10): 717-721.
[28] Kutuby, F., Wang, S., Desai, C. and Lerma, E.V. (2015) Anemia of Chronic Kidney Disease. Disease-a-Month, 61, 421-424. [Google Scholar] [CrossRef] [PubMed]