肾素抑制剂阿利吉仑在非糖尿病肾小球疾病治疗中的应用前景

Application prospect of renin inhibitor Aliskiren in the treatment of nondiabetic glomerulonephritis

非糖尿病性肾小球疾病是导致终末期肾病(end stage renal disease,ESRD)的常见原因。慢性肾脏病进展到一定阶段后均通过肾小管间质纤维化共同途径发展到ESRD,该过程中肾素-血管紧张素-醛固酮系统(RAAS)扮演重要的作用。阻断RAAS系统能延缓慢性肾脏病的进展;ACEI或ARB在肾脏疾病治疗上确实起到重要作用,但仍不令人满意,部分患者蛋白尿仍持续存在。阿利吉仑是第一个非肽类直接肾素抑制剂,不仅可直接作用于RAAS,还可抑制PRR/MAPK/ERK信号通路而起到抗纤维化作用。本文致力于阐述其应用于肾小球疾病的治疗前景。

Non-diabetic glomerulonephritis is a common cause of end stage renal disease（ESRD）.The development of chronic kidney diseases（CKD） to a certain stage is through the common pathway of renal tubule interstitial fibrosis to ESRD,and renin-angiotensin-aldosterone system（RAAS） plays an important role during the process.Blocking RAAS system can delay the progress of CKD.Angiotensin-converting enzyme inhibitor（ACEI） or angiotensin receptor blocker（ARB） exerts a great role,but which still is not satisfying due to persisted proteinuria in some patients.Aliskiren is the first non-peptide direct renin inhibitor,which not only directly influences on RAAS,also blocks the PRR/MAPK/ERK signal pathway with anti-fibrosis.The paper focused on the prospect of applying Aliskiren to glomerulopathy.