尚天则, 张程亮, 刘东. 胆汁性肾病的基础与临床研究进展[J]. 临床肾脏病杂志, 2024, 24(6): 513-516. DOI: 10.3969/j.issn.1671-2390.2024.06.011
    引用本文: 尚天则, 张程亮, 刘东. 胆汁性肾病的基础与临床研究进展[J]. 临床肾脏病杂志, 2024, 24(6): 513-516. DOI: 10.3969/j.issn.1671-2390.2024.06.011
    Shang Tian-ze, Zhang Cheng-liang, Liu Dong. Recent advances of fundamentals and clinical researches of cholemic nephropathy[J]. Journal of Clinical Nephrology, 2024, 24(6): 513-516. DOI: 10.3969/j.issn.1671-2390.2024.06.011
    Citation: Shang Tian-ze, Zhang Cheng-liang, Liu Dong. Recent advances of fundamentals and clinical researches of cholemic nephropathy[J]. Journal of Clinical Nephrology, 2024, 24(6): 513-516. DOI: 10.3969/j.issn.1671-2390.2024.06.011

    胆汁性肾病的基础与临床研究进展

    Recent advances of fundamentals and clinical researches of cholemic nephropathy

    • 摘要: 胆汁性肾病(cholemic nephropathy,CN)是在晚期慢性肝病并发重度黄疸患者中出现的一种以肾功能障碍为主要表现的疾病。目前,CN缺乏有效的无创诊断方法,肾穿刺活检是该病临床诊断的金标准。此外,该病常与肝肾综合征相混淆,漏诊或误诊易贻误治疗使得患者预后较差。CN的临床治疗原则是降低患者高胆红素水平以缓解肾损伤,若药物效果不佳也可采用人工肝系统改善患者肾功能。CN的病理机制尚未完全阐明,近年来的研究表明该病的发病机制包括肾脏转运体异常、胆汁酸损伤以及炎症反应等。基于此,本文主要针对国内外关于CN的研究进展,对其临床诊断、发病机制及治疗现状等方面进行归纳总结,以期为CN的深入研究和临床干预提供一定的理论基础。

       

      Abstract: Cholemic nephropathy (CN) is a disease with renal dysfunction as a major manifestation in patients with advanced chronic liver disease complicated with severe jaundice. Currently no effective non-invasive diagnostic modality is available for CN. Renal biopsy has been a gold standard for its clinical diagnosis. Furthermore, it is frequently misdiagnosed or confused with hepatorenal syndrome so that patient prognosis remains poor. The overall objective of clinical management is lowering a high level of bilirubin and blunting renal injury. If drug therapy fails, artificial liver systems may be employed for improving renal function. The underlying pathological mechanisms of CN have not been fully elucidated. However, recent studies implied that the development of disease was correlated closely with abnormal renal transporters, oxidative stress and inflammatory responses. Based upon previous studies, the authors summarized the latest researches on CN through focusing upon clinical diagnosis, potential pathogenesis and therapeutic strategies for providing theoretical rationales for advanced researches and clinical interventions of CN.

       

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