The pathogenetic mechanisms of acute kidney injury and chronic kidney disease (a literature review)

Authors

  • T. M. Boychuk Higher State Educational Establishment of Ukraine “Bukovinian State Medical University”, Chernivtsi,
  • A. I. Gozhenko State Enterprise “Ukrainian Research Institute for Medicine of Transport”, Ministry of Health of Ukraine, Odesa,
  • N. D. Filipets Higher State Educational Establishment of Ukraine “Bukovinian State Medical University”, Chernivtsi,
  • V. M. Khodorovskyy Higher State Educational Establishment of Ukraine “Bukovinian State Medical University”, Chernivtsi,

DOI:

https://doi.org/10.14739/2310-1210.2018.02.125355

Keywords:

acute kidney injury, chronic kidney disease, pathologic processes

Abstract

Аim – compilation of scientific data on the pathogenetic mechanisms of acute kidney injury and chronic kidney disease.

Although the general pathophysiological picture and the main clinical and laboratory signs of renal damage or comorbid conditions causing CKD have been established, the research of the gradual nephron death mechanisms are still very actual. To date it is unknown why kidney injury initially causes reversible changes, but with the passing of time irreversible acute renal insufficiency occurs or chronic process develops. Broadening pathogenesis knowledge is an important step toward improving early diagnosis and treatment of acute and chronic kidney injury for the maximal postponement of end-stage renal disease.

We have analyzed available scientific literature for the past 5 years that allows formulating the modern concept of the general pattern and the key links in the mechanisms of kidney dysfunction and loss of nephrons homeostatic functions. The results, shown in our own experiments, demonstrate the influence of ATP-dependent potassium (KATP) channel activator flocalin on renal. Defined nephroprotective effects of flocalin on tubular and glomerular parts indicate the pathogenetic role of KATP channels and importance of their pharmacological activation during acute and chronic kidney injury.

Conclusions. Regardless of its etiology acute injury of the nephrocytes proceeds through several mechanisms. The initial compensatory effects of these mechanisms can change to irreversible destructive influence that finally results in reduction in the number of the functioning nephrocytes, chronic kidney disease formation and terminal renal insufficiency. Despite intensive research of pathogenesis and continuous search for the new markers of acute and chronic kidney injury the causes of kidney pathology progression have not been fully disclosed yet. The important medical, social and economic aspects of renal diseases substantiate perspective of the key links further study that form a universal pathophysiological picture and facilitate the pathogenetic directions of pharmacological nephroprotection improvement.

References

Duan, S. B., Liu, G. L., Yu, Z. Q., & Pan P. (2013) Urinary KIM-1, IL-18 and Cys-c as early predictive biomarkers in gadolinium-based contrast-induced nephropathy in the elderly patients. Clin Nephrol., 80(5), 349–354. doi: 10.5414/CN107829.

Singer, E., Markó, L., Paragas, N., Barasch, J., Dragun, D., Müller, D.N., et al. (2013) Neutrophil gelatinase-associated lipocalin: pathophysiology and clinical applications. Acta Physiol (Oxf), 207(4), 663–672. doi: 10.1111/apha.12054.

Makris, K., & Spanou, L. (2016) Acute Kidney Injury: Definition, Pathophysiology and Clinical Phenotypes. Clin Biochem Rev., 37(2), 85–98.

Chawla, L. S., Eggers, P. W., Star, R. A., & Kimmel, P. L. (2014) Acute kidney injury and chronic kidney disease as interconnected syndromes. N Engl J Med., 371(1), 58–66. doi: 10.1056/NEJMra1214243.

Boichuk, Т. М., Rohovyi, Yu. Ye., & Popovych, H. B. (2012) Patofiziolohiia hepatorenalnoho syndromu pry hemichnii hipoksii [Pathophysiology of the hepatic-renal syndrome at the hemic hypoxia]. Chernivtsi. [in Ukrainian].

Boichuk, Т. М., Hordiienko, V. V., & Rohovyi, Yu. Eu. (2016). Khronorytmy nyrok: vikovyi aspekt metalotoksykozu [Circadian rhythms of the kidney: аge aspect in conditions of toxicosis with metals]. Chernivtsi. [in Ukrainian].

Parikh, S. M. (2013) Therapeutic targeting of the mitochondrial dysfunction in septic acute kidney injury. Curr Opin Crit Care., 19(6), 554–559. doi: 10.1097/MCC.0000000000000038.

Ishimoto, Yu., & Inagi, R. (2016) Mitochondria: a therapeutic target in acute kidney injury. Nephrol Dial Transplant, 31(7), 1062–1069. doi: 10.1093/ndt/gfv317.

McIlwain, D. R., Berger, T., & Mak, T. W. (2015) Caspase Functions in Cell Death and Disease. Cold Spring Harbor Perspectives in Biology, 7(4), a026716. doi: 10.1101/cshperspect.a026716.

Gansevoort, R. T., Correa-Rotter, R., Hemmelgarn, B. R., Jafar T. H., Heerspink, H. J., Mann J. F., et al. (2013) Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention. Lancet, 382(9889), 339–352. doi: 10.1016/S0140-6736(13)60595-4.

Derymedvid’, L. V., Drogovoz, S. M., Matveeva, E. V., Kireyev, I. V., & Vereitinova, V. P. (2014) Nefrotoksychnist yak proiav pobichnoi dii likiv [Nephrotoxicity as the manifestation of drugs side effect]. Ukrainskyi farmatsevtychnyi zhurnal, 5, 59–61. [in Ukrainian].

Shahrbaf, F. G., & Assadi F. (2015) Drug-induced renal disorders. Journal of Renal Injury Prevention, 4(3), 57–60. doi: 10.12861/jrip.2015.12.

Vlasyk, L. І., Andriychuk, N. J., Davydenko, I. S. (2014) Osoblyvosti patomorfolohichnykh zmin u nyrkakh shchuriv vnaslidok pidhostroho vplyvu sribnykh nanodekaedriv [Peculiarities of pathomorphological changes in internal organs of rats as a result of subacute effect of silver nanodecahedrons]. Klinichna ta eksperymentalna patolohiia, 13(3), 33–36. [in Ukrainian].

Petejova, N., & Martinek, A. (2014) Acute kidney injury due to rhabdomyolysis and renal replacement therapy: a critical review. Critical Care, 18(3), 224. doi: 10.1186/cc13897.

Azzalini, L., Spagnoli, V., & Ly, H. Q. (2016) Contrast-induced nephropathy: from pathophysiology to preventive strategies. Can J Cardiol., 32(2), 247–255. doi: 10.1016/j.cjca.2015.05.013.

Sancho-Martinez, S. M., Lopez-Novoa, J. M., & Lopez-Hernandez, F. J. (2015) Pathophysiological role of differenttubular epithelial cell death modes in acute kidney injury. Clin. Kidney J., 8, 548–559. doi: 10.1093/ckj/sfv069.

Lee, K., Boctor, S., Barisoni L. M., & Gusella G. L. (2015) Inactivation of integrin-β1 prevents the development of polycystic kidney disease after the loss of polycystin-1. J Am Soc Nephrol., 26(4), 888–895. doi: 10.1681/ASN.2013111179.

Inker, L. A., Astor, B. C., Fox, C. H., Isakova, T., Lash, J. P., Peralta, C. A., et al. (2014). KDOQI US Commentary on the 2012 KDIGO Clinical Practice Guideline for the Evaluation and Management of CKD. Am J Kidney Dis., 63(5), 713–735. doi: 10.1053/j.ajkd.2014.01.416.

Noone, D., & Licht, C. (2014) Chronic kidney disease: a new look at pathogenetic mechanisms and treatment options. Pediatr Nephrol., 29(5), 779–792. doi: 10.1007/s00467-013-2436-5.

Kuzmin, O. B. (2015). Khronicheskie bolezni pochek: mekhanismy razvitiya i progressirovaniya gipoksicheskogo glomeruloskleroza i tubulointerstitsialnogo fibrosa. [Chronic kidney disease: mechanisms of hypoxic glomerulosclerosis and tubulointerstitial fibrosis development and progression]. Nefrologiya, 19(4), 6–16. [in Russian].

Gozhenko, A. I., Kravchuk, A. V., Nikitenko, O. P., Moskalenko, O. M., & Sirman, V. M. (2015) Funktsionalnyi nyrkovyi rezerv [Functional Renal Reserve]. Оdessa: Feniks. [іn Ukrainian].

Kawakami, T., Mimura, I., Shoji, K., Tanaka, T., & Nangaku, M. (2014) Hypoxia and fibrosis in chronic kidney disease: crossing at pericytes. Kidney Int. Suppl., 4(1), 107–112. doi: 10.1038/kisup.2014.20.

Zhang, H., & Sun, S. C. (2015) NF-κB in inflammation and renal diseases. Cell & Bioscience, 5(63), 1–12. doi: 10.1186/s13578-015-0056-4.

Haase, V. H. (2013) Mechanisms of hypoxia responses in renal tissue. J Am Soc Nephrol., 24(4), 537–541. doi: 10.1681/ASN.2012080855.

Kanasaki, K., Taduri, G., & Koya, D. (2013) Diabetic nephropathy: the role of inflammation in fibroblast activation and kidney fibrosis. Front Endocrinol (Lausanne), 4, 7. doi: 10.3389/fendo.2013.00007.

Erkan, E. (2013) Proteinuria and progression of glomerular diseases. Pediatr Nephrol., 28(7), 1049–1058. doi: 10.1007/s00467-012-2335-1.

Tang, S. C., Yiu, W. H., Lin, M., & Lai, K. N. (2015) Diabetic nephropathy and proximal tubular damage. J Ren Nutr., 25(2), 230–233. doi: 10.1053/j.jrn.2014.10.020.

Carlström, M., Wilcox, C. S., & Arendshorst W. J. (2015) Renal Autoregulation in Health and Disease. Physiological Reviews, 95(2), 405–511. doi: 10.1152/physrev.00042.2012.

Filipec, N. D., & Gozhenko, A. I. (2014) Sravnitelnaya ocenka nefroprotektivnykh svojstv modulyatorov kalievykh i cal'cievykh kanalov pri e'ksperimental'nom porazhenii pochek [A comparative assessment of nephroprotective properties of potassium and calcium channel modulators in experimental renal injury]. E'ksperimental'naya i klinicheskaya farmakologiya, 77(1), 10–12. [іn Russian].

Gozhenko, A. I., & Filipec, N. D. (2013). Nefrotropnye e'ffiekty pri akivacii adenozintrifosfatchuvstvitel'nykh kalievykh kanalov v zavisimosti ot funkcional'nogo sostoyanya pochek krys [The renotropic effects of adenosine triphosphate-sensitive potassium channel activation depending on the functional state of kidneys]. Nefrologiya, 17(2), 87–90. [іn Russian].

Gozhenko, A. I., & Filipets, N. D. (2014) Funktsionalnyi stan nyrok pislia aktyvatsii adenozyntryfosfatchutlyvykh kaliievykh kanaliv pry eksperymentalnii hostrii hipoksii [Тhe functional state of kidneys after adenosine triphosphate sensitive potassium channels activation in experimental acute hypoxia]. Fiziolohichnyi zhurnal, 60(4), 22–29. [іn Ukrainian].

Filipets, N. D., Sirman, V. M., & Gozhenko, A. I. (2014) Vliyanie modulyatorov ionnykh kanalov na funkciyu pochek v nachal'noj stadii razvitiya gistogemicheskoj gipoksii [Effects of modulators of ion channels on renal function at the initial stage of development of histohemic hypoxia]. Zhurnal Natsiaonalnoi akademii medychnykh nauk Ukrainy, 20(4), 483–487 [іn Ukrainian].

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How to Cite

1.
Boychuk TM, Gozhenko AI, Filipets ND, Khodorovskyy VM. The pathogenetic mechanisms of acute kidney injury and chronic kidney disease (a literature review). Zaporozhye Medical Journal [Internet]. 2018Mar.7 [cited 2024Oct.10];(2). Available from: http://zmj.zsmu.edu.ua/article/view/125355

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