Frascà Giovanni M, Nastasi Valentina, Balestra Emilio, Gaffi Giovanni, Taruscia Domenica, D'Arezzo Mario, Sagripanti Sibilla
Nefrologia e Dialisi, Ospedali Riuniti, Ancona, Italy.
G Ital Nefrol. 2010 Nov-Dec;27 Suppl 52:S73-7.
Chronic allograft nephropathy, characterized by interstitial fibrosis and tubular atrophy, is one of the main causes of allograft failure in the long term. It may be induced by several factors, immunogical or not in nature, which nephrologists must recognize in order to establish the appropriate treatment strategy and prevent progressive loss of graft function. Extensive use of graft biopsy, whether carried out by protocol or suggested by the clinical setting, is recommended for an accurate diagnosis of renal lesions and prompt identification of calcineurin inhibitor-induced toxicity or signs of immunological activity (i.e., subclinical rejection or chronic antibody-mediated rejection) requiring changes of immunosuppressive strategy.
慢性移植肾肾病以间质纤维化和肾小管萎缩为特征，是长期移植肾失功的主要原因之一。它可能由多种因素诱发，这些因素在本质上有无免疫性，肾病学家都必须认识到，以便制定适当的治疗策略并防止移植肾功能的渐进性丧失。对于准确诊断肾脏病变以及迅速识别钙调神经磷酸酶抑制剂诱导的毒性或免疫活性迹象（即亚临床排斥或慢性抗体介导的排斥）从而需要改变免疫抑制策略而言，建议广泛进行移植肾活检，无论是按照方案进行还是根据临床情况建议进行。
