腹膜纤维化机制与治疗新进展

Mechanisms and prospects of interventions in the peritoneal fibrosis

腹膜透析作为一种有效的肾脏替代治疗,在终末期肾病中运用日渐广泛,甚至成为肾脏替代治疗的首选方案。但长期的腹膜透析会导致腹膜功能下降、腹膜结构改变,最终演变成腹膜纤维化,甚至包裹性腹膜硬化症,使超滤失败,严重时使患者退出腹膜透析。目前国内外研究主要包括:上皮细胞一间充质转化、腹膜透析液的生物不相容性、血管紧张素一醛固酮系统、氧化应激、腹膜炎症、全身微炎症状态、基因调控、生长及转化因子等,针对上述发病机制,提出了相应的治疗方法。

As an effective renal replacement therapy, peritoneal dialysis is widely used in patients with end-stage kidney disease.However, long-term peritoneal dialysis will progress to peritoneal fibrosis even encapsulating peritoneal sclerosis with functional and structural alterations of the peritoneal membrane. Peritoneal fibrosis can cause the failure of ultrafiltration and eventually make patients withdrawal from PD. The objective of this review is to summarize the mechanisms of peritoneal fibrosis from a new perspective, and conclude current and future prospects of interventions in the peritoneal fibrosis.