老年常见慢性肾脏纤维化疾病诊疗的研究进展

doi:10.3969/j.issn.1003-9198.2026.07.002

摘要/Abstract

摘要： 慢性肾脏病(chronic kidney disease, CKD)是我国十分常见、危害极大的慢性非传染性疾病之一,对老年人群健康有直接且重大的威胁。慢性肾脏纤维化是CKD进展最明确、最重要的病理基础:在老年人群中,肾脏纤维化往往是多种CKD进展到后期的共同结果,常见于高血压肾硬化症、糖尿病肾病、缺血性肾病、慢性肾小球肾炎、高尿酸血症肾病、药物性肾损伤、梗阻性肾病。更严峻的是,目前肾脏纤维化的临床诊疗尚存在传统诊断手段不能早期、准确地反映肾间质纤维化程度,不能有效逆转已有纤维化,且老年患者多病共存、多重用药,诸种因素相互叠加等问题。因此,探索新的诊断技术及治疗策略是突破该领域瓶颈的关键。本文系统梳理了上述常见老年肾脏纤维化疾病的核心机制,综述了近年来的诊断技术及治疗策略研究进展,以期为临床实践和未来研究提供参考。

关键词: 老年人, 慢性肾脏纤维化, 高血压肾硬化症, 糖尿病肾病, 缺血性肾病, 抗纤维化治疗

Abstract: Chronic kidney disease (CKD) is one of the most common and highly harmful chronic non-communicable diseases in China, posing a direct and significant threat to the health of the elderly population. Chronic renal fibrosis in the elderly is the most definitive and important pathological basis for the progression of CKD. In the elderly, renal fibrosis is often the result of various CKD progressing to an advanced stage, and is commonly seen in hypertensive nephrosclerosis, diabetic nephropathy, ischemic nephropathy, chronic glomerulonephritis, hyperuricemic nephropathy, drug-induced kidney injury, and obstructive nephropathy. More critically, current clinical diagnosis and treatment face multiple challenges: traditional diagnostic methods cannot accurately and early reflect the extent of renal interstitial fibrosis; existing fibrosis cannot be effectively reversed; and elderly patients often suffer from multiple comorbidities and polypharmacy. These factors collectively compound the difficulties. Therefore, exploring new diagnostic technologies and therapeutic strategies are keys to breaking through the bottlenecks in this field. This article systematically reviews the core mechanisms of the aforementioned common elderly renal fibrotic diseases, summarizes recent advances in diagnostic technologies and therapeutic strategies, and aims to provide a reference for clinical practice and future research.

Key words: aged, chronic renal fibrosis, hypertensive nephrosclerosis, diabetic nephropathy, ischemic nephropathy, anti-fibrotic therapy

中图分类号:

R 692

曾妙, 雷佳炜, 王晟. 老年常见慢性肾脏纤维化疾病诊疗的研究进展[J]. 实用老年医学, 2026, 40(7): 651-657.

ZENG Miao, LEI Jiawei, WANG Sheng. Research progress in the diagnosis and treatment of common chronic renal fibrosis diseases in the elderly[J]. Practical Geriatrics, 2026, 40(7): 651-657.

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