Hewamana Saman, Pepper Chris, Jenkins Chris, Rowntree Clare
Department of Haematology, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN, UK.
Department of Haematology, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK.
Clin Exp Nephrol. 2009 Apr;13(2):179-181. doi: 10.1007/s10157-009-0129-y. Epub 2009 Mar 3.
Chronic lymphocytic leukaemia (CLL) is a neoplastic condition of B cells which commonly affects the lymph nodes, liver, spleen and bone marrow. Leukaemic involvement of the kidney is also relatively common in CLL, but characteristically is not associated with renal impairment. Our report describes a patient who developed acute renal failure as the initial presenting feature of CLL. The renal failure was subsequently found to be due to direct leukaemic infiltration. Treatment with chlorambucil and prednisolone resulted in stabilisation of the renal function for approximately 1 year prior to the need for long-term haemodialysis. Leukaemic infiltration of kidney should always be considered when a patient with CLL presents with renal impairment, regardless of the clinical stage, as the renal failure often responds well to chemotherapy.
慢性淋巴细胞白血病（CLL）是一种B细胞的肿瘤性疾病，通常累及淋巴结、肝脏、脾脏和骨髓。CLL患者肾脏受白血病累及也相对常见，但典型的是不伴有肾功能损害。我们的报告描述了一名以急性肾衰竭为CLL首发表现的患者。随后发现肾衰竭是由于白血病直接浸润所致。使用苯丁酸氮芥和泼尼松龙治疗使肾功能在需要长期血液透析前稳定了约1年。当CLL患者出现肾功能损害时，无论临床分期如何，都应始终考虑白血病浸润肾脏，因为肾衰竭通常对化疗反应良好。
