“衰竭的星球上衰竭的肾脏;病因不明的CKD”。

IF 3 4区 医学 Q2 ENVIRONMENTAL SCIENCES Reviews on Environmental Health Pub Date : 2023-03-28 DOI:10.1515/reveh-2021-0109
Eleni Geladari, Natalia Vallianou, Charalampia Geladari, Konstantinos Aronis, Konstantinos Vlachos, Emmanuel Andreadis, Ioannis Theocharopoulos, Spyros Dourakis
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引用次数: 3

摘要

气候医学时代的人类“闹钟”已经敲响。原来的疾病已经出现,无法解释并归因于共同原因,这被认为与全球变暖和环境因素有关。这样一种惰性疾病是不明原因的慢性肾脏疾病(CKDu),也被称为中美洲肾病或Uddanam肾病。科学家把气候对肾脏的影响等同于煤矿里的金丝雀;煤矿工人过去常常把金丝雀关在笼子里,这样,如果有毒气体,如甲烷或一氧化碳泄漏到矿井里,这些气体会在杀死矿工之前杀死金丝雀;同样,在人类发生毁灭性和致命的并发症之前,肾脏也会受到损伤。在中美洲的一些地区,慢性肾脏疾病造成的死亡增加了177%,死亡人数高达2万多人。首先在动物身上发现,周期性的高温和脱水是导致慢性肾脏疾病的主要原因。基于这一观察,我们主张中美洲和南亚的年轻男性农业工人由于反复暴露在极端高温下而患上肾脏疾病。这种类型肾损伤的临床病理特征不属于现有的分类,尽管已经提出了一种肾小管间质性疾病的形式。在这篇综述中,我们将讨论CKDu,其流行病学和病理生理机制,临床表现和诊断生物标志物,并探讨潜在的治疗方案。
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"Failing kidneys in a failing planet; CKD of unknown origin".

The 'alarm clock' for human beings in the era of climate medicine has rung. Original diseases have appeared, that could not be explained and attributed to common causes, which are suggested to be linked to global warming and environmental factors. Such an indolent disease is the chronic kidney disease of unknown cause (CKDu), introduced also as Mesoamerican or Uddanam nephropathy. Scientists equate the climate impact on kidneys with the canary in the coal mine; coal miners used to carry caged canaries with them, so that if poisonous gases, such as methane or carbon monoxide leaked into the mine-shaft, the gases would kill the canary before killing the miners; similarly, kidneys are injured before devastating and lethal complications occur in humans. In some regions of Central America, the deaths due to chronic kidney disease increased by 177% with a death toll being as high as over 20,000. It was first documented in animals that periodic heat and dehydration have a major role in causing chronic kidney disease. Based on that observation, it is advocated that young male agricultural workers in Central America and South Asia, develop renal disease by getting exposed to extreme heat repeatedly. The clinico-pathological characteristics of this type of kidney injury, do not belong to an existing classification, even though a form of tubulo-interstitial renal disease has been proposed. In this review, we will discuss about CKDu, its epidemiology and pathophysiological mechanisms, clinical presentation and diagnostic biomarkers and examine potential therapeutic options.

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来源期刊
Reviews on Environmental Health
Reviews on Environmental Health Social Sciences-Health (social science)
CiteScore
7.20
自引率
2.60%
发文量
75
期刊介绍: Reviews on Environmental Health (REVEH) is an international peer-reviewed journal that aims to fill the need for publication of review articles on hot topics in the field of environmental health. Reviews on Environmental Health aims to be an inspiring forum for scientists, environmentalists, physicians, engineers, and students who are concerned with aspects of human health, including quality of life, that are determined by physiological and psychosociological interactions between man and physical, chemical, biological, and social factors in the environment. Reviews on Environmental Health is an important niche served by no other journal, that’s being a site where thoughtful reviews can be published on a variety of subjects related to both health and environment. One challenge is to bridge the research on environmental causes of disease with the clinical practice of medicine. Reviews on Environmental Health is a source of integrated information on environment and health subjects that will be of value to the broad scientific community, whether students, junior and senior professionals, or clinicians.
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