Adverse effects of acute tubular injury on the glomerulus: contributing factors and mechanisms.

Autor: Babickova J; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, MCN C3318, Nashville, TN, 37232, USA.; Department of Clinical Medicine, University of Bergen, Bergen, Norway.; Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia., Yang HC; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, MCN C3318, Nashville, TN, 37232, USA., Fogo AB; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, MCN C3318, Nashville, TN, 37232, USA. agnes.fogo@vumc.org.
Jazyk: angličtina
Zdroj: Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2024 Aug; Vol. 39 (8), pp. 2301-2308. Date of Electronic Publication: 2024 Jan 08.
DOI: 10.1007/s00467-023-06264-7
Abstrakt: The intricate relationship between tubular injury and glomerular dysfunction in kidney diseases has been a subject of extensive research. While the impact of glomerular injury on downstream tubules has been well-studied, the reverse influence of tubular injury on the glomerulus remains less explored. This paper provides a comprehensive review of recent advances in the field, focusing on key pathways and players implicated in the pathogenesis of tubular injury on glomerular dysfunction. Anatomical and physiological evidence supports the possibility of crosstalk from the tubule to the glomerulus, whereby various mechanisms contribute to glomerular injury following tubular injury. These mechanisms include tubular backleak, dysfunctional tubuloglomerular feedback, capillary rarefaction, atubular glomeruli, and the secretion of factors from damaged tubular epithelial cells. Clinical evidence further supports the association between even mild or recovered acute kidney injury and an increased risk of chronic kidney disease, including glomerular diseases. We also discuss potential therapeutic interventions aimed at mitigating acute tubular injury, thereby reducing the detrimental effects on glomerular function. By unraveling the complex interplay from tubular injury to glomerular dysfunction, we aim to provide insights that can enhance clinical management strategies and improve outcomes for patients with kidney disease.
(© 2024. The Author(s), under exclusive licence to International Pediatric Nephrology Association.)
Databáze: MEDLINE
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