Lodhi Ahad, Kumar Abhishek, Saqlain Muhammad U, Suneja Manish
Department of Nephrology, Internal Medicine , University of Iowa Hospitals and Clinics , Iowa City, IA 52246 , USA.
Clin Kidney J. 2015 Oct;8(5):632-6. doi: 10.1093/ckj/sfv059. Epub 2015 Jul 16.
The ubiquitin proteasome pathway plays a key role in cell cycle, function and survival. Bortezomib (BTZ) and Carfilzomib (CFZ) are the first two inhibitors of the proteasome pathway, indicated in treatment of patients with multiple myeloma. In the past few years, there have been few case reports that have highlighted the association between proteasome inhibitors (BTZ and CFZ) with acute kidney injury (AKI). In most of these case reports and initial trials, the underlying mechanism of AKI has been unclear. In this article, we discuss the association and pathogenesis of proteasome inhibitors-associated AKI. We also report the first case of CFZ-associated AKI with kidney biopsy evidence of thrombotic microangiopathy and the presence of microangiopathic hemolytic anemia.
泛素蛋白酶体途径在细胞周期、功能及存活中发挥关键作用。硼替佐米（BTZ）和卡非佐米（CFZ）是蛋白酶体途径的前两种抑制剂，被用于治疗多发性骨髓瘤患者。在过去几年里，鲜有病例报告强调蛋白酶体抑制剂（BTZ和CFZ）与急性肾损伤（AKI）之间的关联。在大多数这些病例报告及初步试验中，AKI的潜在机制尚不清楚。在本文中，我们讨论蛋白酶体抑制剂相关AKI的关联及发病机制。我们还报告了首例有肾活检血栓性微血管病证据及微血管病性溶血性贫血存在的CFZ相关AKI病例。
