NONSPECIFIC MECHANISMS OF CHRONIC KIDNEY DISEASE PROGRESSION

Abstract

The authors of the review have analyzed papers published on the problem of pathogenesis chronic kidney disease (CKD), which the experts of the K/DOQI (Kidney Disease Outcomes Quality Initiative) Advisory Board (National Kidney Foundation, USA) is defined as the presence of kidney damage or decreased level of kidney function for three months or more, irrespective of diagnosis. It is shown that the specific mechanisms which result directly from the nature of the disease, completely determine the course of CKD in its initial stage, whereas further reduction in the number of intact nephrons, cascade is initiated univer-sal for all of nephropathy pathological processes, culminating in the formation of nephrosclerosis, often even if the reason that caused the initial damage to the nephrons is eliminated: hyperfiltration, hypercoag-ulability, impaired renal transport protein, changes in the expression of mediators of cell damage, meta-bolic and endocrine mechanisms, polymorphism of genes controlling the expression of nephrotropic bio-logically active substances. Analyzed published data demonstrate that renal protection strategy (complex therapies aimed at the inhibition of the irreversible deterioration of kidney function and affect common to all of nephropathy mechanisms of progression) can slow the progression of CKD.

Keywords

• хроническая болезнь почек
• патогенез
• неспецифические механизмы прогрессирования
• гиперфильтрация
• протеинурия
• гиперкоагуляция
• воспаление
• нефропротекция