积极宣传世界肾脏日,唤起全社会对慢性肾脏病的重视

最近．国际肾脏病学会（ISN）和肾脏病基金联合会（IFKF）联合倡议每年3月份的第2个星期四建立世界肾脏日（World Kidney Day），首个世界肾脏日定为2006年3月9日。希望借此唤起全球对高发病率和严重危害性的慢性肾脏病（chronic kidney disease，CKD）的认识、关注和重视，其宗旨是激励医护人员、卫生部官员和政府部门政策的决策者能真正行动起来．最大限度减轻这个尚未被社会充分认识和重视的疾病杀手——慢性肾脏病对社会和个人的巨大压力和危害。     

迎接挑战，扎实工作，实现慢性肾脏病防治的优化

不久前，国际肾脏病学会（ISN）和国际肾脏基金联合会（IFKF）联合发出倡议，将每年3月份的第2个星期四（今年是3月9日）定为“世界肾脏日”。正如ISN和IFKF倡议中所说，设立“世界肾脏日”的主要目的，就是要在全世界敲起警钟．唤起全人类对慢性肾脏病（CKD）的高度关注。稍后，中华医学会肾脏病学分会也发出倡议，并举办了一系列有关活动，倡议政府官员、社会各界、大众媒体、全体医药卫生人员乃至每个家庭和个人，都来关注和重视CKD的预防和治疗，为提高国人健康水平和生活质量而共同奋斗。     

沉痛悼念“中国肾脏病学之母”王海燕教授

惊闻北京大学第一医院肾脏病研究所所长、我国著名肾脏病学专家、本刊顾问王海燕教授因突发心脏病医治无效，于2014年12月11日凌晨3：52分在北京不幸逝世，享年77岁。王海燕教授是我国著名的肾脏病专家，曾任北京大学肾脏疾病研究所所长、国际肾脏病学会（ISN）全球发展委员会东亚地区主席、ISN慢性肾脏病战略研究工作组成员、改善全球。肾脏病预后组织（KDIGO）顾问委员会委员、亚洲慢性肾脏病协会（AFCKDI）国际顾问委员会主席、国际肾脏病学会常务理事、中华医学会肾脏病学分会主任委员、中华医学会内科学分会主任委员等职。     

2型糖尿病肾损害的临床和病理研究现状

2007年美国肾脏病基金会（NKF）制定了第一个针对糖尿病并发慢性肾脏疾病（CKD）的指南《糖尿病及慢性肾脏病临床实践指南》^[1]，并提出糖尿病肾脏疾病（diabetic kidney disease，DKD）和糖尿病肾小球病（diabetic glomerulopathy，DG）的新概念拟取代糖尿病肾病（diabetic nephropathy，DN）。与1型糖尿病导致的DKD相比，无论是发病机制、临床和病理表现，还是诊断、治疗、合并症与预后，     

慢性肾脏病的定义与分期-从KDOQI到KDIGO:贡献与问题

慢性肾脏病（CKD）的定义和分期标准是美国国家肾脏基金会（National Kidney Foundation，NKF）所属“肾脏病预后质量倡议”（Kidney Disease Outcomes Quality Initiative，KDOQI）工作组于2002年制定。     

成人慢性肾脏疾病：英国诊断、管理和治疗指南

因慢性肾脏疾病（CKD）而接受肾脏替代治疗（RRT）的人数正在迅速增长，若CKD患者到疾病晚期才得到治疗，治疗费用会更高，且临床预后更差。大多数开始RRT的患者应该得到更早的诊断和治疗。为此，伦敦皇家医师协会肾脏病专家联合会会同肾病协会发起，六家相关学会参与，用了三年的时间（2002-2005年），共同制定了英国慢性肾脏病指南。该指南最终于2006年3月公开发表，委员会计划于2009年修改此指南。Raymond Vanholder（比利时）认为，“这是一个很有用的指南，它广泛覆盖了非透析的慢性肾脏疾病患者可能面临的问题，包括了许多治疗上长期忽略和新出现的问题”。     

胰岛素抵抗与慢性肾脏病患者的相关性分析

胰岛素抵抗（insulin Resistance,IR）是指机体靶细胞对循环中一定量的胰岛素产生的生物学效应低于实际应有水平的一种状态,即组织对胰岛素的敏感性降低。慢性肾脏病（chronic kidney disease,CKD）,是各种慢性肾脏损害的总称,包括原发性肾脏病（如：慢性肾小球炎、原发性肾脏肿瘤、慢性肾盂肾炎、肾病综合征、多囊肾等遗传性肾脏病、肾囊肿、肾结石等）和继发性肾脏病（高血压肾损害、糖尿病肾病、痛风肾病、过敏性紫癜肾炎、狼疮性肾炎等）。据估计,     

第四期慢性肾衰一体化治疗新进展学习班招生

上海交通大学医学院附属瑞金医院将于2006年10月9—14日举办国家级继续医学教育项目——第四期慢性肾衰一体化治疗新进展学习班（项目编号2006305019）。内容包括慢性肾衰这一常见病症及肾脏替代这一现代临床医学的热点内容。融入国际上现代肾脏病学、器官移植学、及移植免疫学的新概念及新趋势。并由长期从事肾脏病、肾脏移植及移植免疫的专家周光炎、陈楠、徐达、王祥慧等教授，结合丰富的临床实践经验讲授相关内容。招生对象为全国各医院肾内科、内科和泌尿外科医师、研究生等。学期6天，参加者可获得国家级I类学分13分。欲参加者请速来函索取报名表：上海市瑞金二路197号瑞金医院肾内科冯晓蓓医师或泌尿外科赵菊平医师收（邮编200025）。电话（021）64370045转665757或666072。截止日期2006年10月9日。     

低氧与慢性进展性肾脏疾病

多数慢性肾脏病存在着进行性发展，即所谓的进展性肾脏病（PRD），最终进展至终末期肾衰竭。目前关于PRD进展机制的学说很多。上世纪末英国学者Fine提出的“慢性低氧学说”正日益受到重视．它强调了肾脏小管间质的慢性氧缺失在肾脏疾病进展中的重要作用。低氧可诱导肾脏固有细胞产生多种细胞因子和炎症介导素，在肾脏病的发生和发展中可能起重要作用。我们现对近期PRD与低氧关系的研究进展作一综述。     

醛固酮与肾脏纤维化

慢性肾脏病（CKD）及其引起的终末期肾病（ESRD）近年来在全球范围内的发病率和患病率呈迅速增长的趋势，已成为世界范围内的严重危害人类健康的公共卫生问题。因此，对CKD进行早期积极干预，防止或延缓其进展，已成为国际、国内肾内科领域关注的焦点。肾脏纤维化是各种不同病因的慢性肾脏疾病进展至终末期肾病的最终共同病理过程，是指在各种致病因子的作用下，     

Kidney

<正>209098 Effects of silencing TGF-β1 by RNA interference plasmid on extracellular matrix synthesis of rat renal allograft/Xia Yuguo(夏雨果,Dept Urol,1st Affil Hosp,Chongqing Med Univ,Chongqing 400016)…∥Chin J Organ Transplant. -2009,30(10). -585～588 Objective To investigate the effects of shRNA-TGF-β1 plasmid on extracellular matrix synthesis of rat renal allograft.     

Kidney transplantation

Renal transplantation is well established as the treatment of choice for selected patients with end-stage renal failure. A renal transplant recipient can enjoy an improved quality of life while benefiting from a reduction in the mortality compared with long-term dialysis. However, the success of transplantation is limited by the disparity between an ever growing demand and an insufficient supply of organs. Expansion of the organ donor pool has been achieved through increased utilization of living donor kidneys, transplantation across HLA and ABO boundaries, as well as a greater acceptance and consideration of more marginal kidneys from deceased donors. While 1-year graft survival rates are significantly higher than a decade ago, the rate of chronic graft loss after the first year remains substantial. Although the surgical procedure has changed little over many years, recipients have certainly become more complex with increasing age, obesity, comorbidity and repeat transplants.     

Kidney transplantation

Renal transplantation is well established as the treatment of choice for selected patients with end-stage renal failure. A renal transplant recipient can enjoy an improved quality of life whilst benefiting from a reduction in the mortality compared with long-term dialysis. However, the success of transplantation is limited by the disparity between an ever growing demand and an insufficient supply of organs. Expansion of the organ donor pool has been achieved through increased utilization of living donor kidneys, transplantation across HLA and ABO boundaries as well as a greater acceptance and consideration of more marginal kidneys from deceased donors. Whilst one-year graft survival rates are significantly higher than a decade ago, the rate of chronic graft loss after the first year remains substantial. Although the surgical procedure has changed little over many years recipients have certainly become more complex with increasing age, obesity, co-morbidity and repeat transplants.     

Kidney cancer

PURPOSE: We quantified the burden of kidney cancer in the United States by identifying trends in the use of health care resources and estimating the economic impact of the disease. MATERIALS AND METHODS: The analytical methods used to generate these results were described previously. RESULTS: The incidence of all stages of kidney cancer is increasing in America, particularly T1 disease. Rates are increasing more rapidly in the black than in the white population and survival is worse for black individuals at all stages of diagnosis. Total expenditures for kidney cancer were $401 million in 2000, representing a 46% increase from 1994. Approximately 85% of health care dollars spent on kidney cancer were for inpatient care with steady increases through the 1990s. Regarding treatment, more partial nephrectomies were performed in Medicare patients as the 1990s progressed. Health Care Cost and Utilization Project data showed an increase in the number of inpatient hospitalizations but this trend was not seen in the Centers for Medicare and Medicaid Services data set. Length of stay decreased from 1994 to 2000 in the Health Care Cost and Utilization Project database. The adoption of laparoscopic techniques began to appear in the Veterans Affairs data set in 2001 and it increased thereafter. CONCLUSIONS: Increasing trends in the incidence of and costs associated with kidney cancer have been apparent for more than 10 years. As the population ages and the prevalence of risk factors such as obesity and hypertension increases, the burden of disease will increase significantly. Consideration should be given to expanding tumor registries such as Surveillance, Epidemiology and End Results. Treatment databases could better characterize the cost and effectiveness of treatment for metastatic disease and of trends in the adoption of laparoscopy.