Cagnoli Leonardo
U.O.C. di Nefrologia e Dialisi, Ospedale degli Infermi, Rimini, Italy.
G Ital Nefrol. 2010 Sep-Oct;27 Suppl 50:S51-7.
Neoplastic diseases can cause renal damage directly or indirectly. Also their treatment can provoke renal damage. The incidence and prevalence of paraneoplastic glomerulonephritis, especially associated with solid tumors, are a matter of debate and the causal link between cancer and glomerular diseases remains unclear. Paraneoplastic glomerulonephritis is a rare occurrence, with a slightly higher prevalence in the elderly. The most common cancer types associated with paraneoplastic glomerular disease are carcinoma of the lung and the gastrointestinal tract. Membranous nephropathy is the most frequent but not the only presentation of paraneoplastic glomerulonephritis. Patients with unexplained nephrotic syndrome, especially if older than 60 years, with membranous nephropathy and/or with their own risk factors for malignancies should be screened for occult cancer at diagnosis and be followed up carefully after the diagnosis. The primary treatment of paraneoplastic glomerulopathy must be aimed at the cancer and immunosuppressive treatment must obviously be avoided.
肿瘤性疾病可直接或间接导致肾损害。其治疗也可能引发肾损害。副肿瘤性肾小球肾炎的发病率和患病率，尤其是与实体瘤相关的情况，存在争议，癌症与肾小球疾病之间的因果关系仍不明确。副肿瘤性肾小球肾炎较为罕见，在老年人中的患病率略高。与副肿瘤性肾小球疾病相关的最常见癌症类型是肺癌和胃肠道癌。膜性肾病是副肿瘤性肾小球肾炎最常见但并非唯一的表现形式。对于原因不明的肾病综合征患者，尤其是年龄超过60岁、患有膜性肾病和/或有自身恶性肿瘤危险因素的患者，在诊断时应筛查隐匿性癌症，并在诊断后进行仔细随访。副肿瘤性肾小球病的主要治疗必须针对癌症，显然应避免免疫抑制治疗。
