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肾脏病与透析肾移植杂志 ›› 2026, Vol. 35 ›› Issue (2): 164-168.DOI: 10.3969/j.issn.1006⁃298X.2026.02.013

• 肾脏病基础 • 上一篇    下一篇

急性肾损伤进展至慢性肾脏病的机制研究进展

  

  • 出版日期:2026-04-28 发布日期:2026-04-23

Advances on the mechanism of acute kidney injury to chronic kidney disease

  • Online:2026-04-28 Published:2026-04-23

摘要: 急性肾损伤 (AKI) 是临床上常见的肾脏疾病,近年研究发现,AKI 也是慢性肾脏病 (CKD) 患病率持续升高的重要原因。深入理解其分子机制,对改善患者预后及防治 CKD 具有关键临床意义。本文系统综述 AKI 向 CKD 转变的核心机制,从多维度解析这一连续病理过程。在细胞层面,探讨肾小管上皮细胞周期停滞、衰老及代谢重编程如何促使其从修复者转变为促纤维化信号源;在免疫层面,分析巨噬细胞持续活化与淋巴细胞浸润如何维持慢性炎症,推动纤维化;在分子层面,阐述表观遗传调控与代谢记忆在形成肾脏 “分子伤疤” 中的作用。通过梳理现有研究,探讨 AKI 向 CKD 转变的潜在机制及干预策略,为改善患者预后提供新思路。

关键词: 急性肾损伤, 慢性肾脏病, 机制, 炎症反应, 纤维化

Abstract: Acute kidney injury (AKI) is a common kidney disease in clinical practice.Recent studies have shown that AKI is not only a short⁃term condition but can also progress to chronic kidney disease (CKD),becoming an important factor contributing to the continuously increasing prevalence of CKD.A deeper understanding of its molecular mechanisms is crucial for improving patient outcomes and preventing CKD.This article provides a systematic review of the core mechanisms underlying the transition from AKI to CKD,analyzing this continuous pathological process from multiple dimensions:at the cellular level,it explores how cell cycle arrest,senescence,and metabolic reprogramming of renal tubular epithelial cells promote their transformation from repair agents to sources of pro⁃fibrotic signals;at the immune level,it examines how persistent macrophage activation and lymphocyte infiltration maintain chronic inflammation and drive fibrosis;at the molecular level,it explains the roles of epigenetic regulation and metabolic memory in forming renal ‘molecular scars.’ By reviewing existing studies,this article aims to explore the potential mechanisms and intervention strategies for the progression of AKI to CKD,providing new insights into improving patient prognosis.

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