Nakai Kentaro, Fujii Hideki, Kono Keiji, Goto Shunsuke, Nishi Shinichi
Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Nephrology and Kidney Center, Kakogawa Central City Hospital, Kakogawa, Japan.
Ther Apher Dial. 2017 Aug;21(4):320-325. doi: 10.1111/1744-9987.12537. Epub 2017 May 23.
Malignancy is a major cause of mortality in dialysis patients. Although molecular-targeted anticancer drugs, including tyrosine-kinase inhibitors, are used for advanced renal cell carcinoma treatment, there are few reports on their effectiveness and safety in dialysis patients. Renal cell carcinoma dialysis patients treated at our hospital from 2010 to 2013 participated in this study. Thirteen patients were treated with tyrosine-kinase inhibitors and 15 patients with surgery only (control group). During treatment, blood pressure changes and dry weight reduction tended to be greater in the tyrosine-kinase inhibitor group than in controls. More intensive management of hypertension was necessary in the tyrosine-kinase inhibitor group than in the controls. Renal cell carcinoma treatment by tyrosine-kinase inhibitors increased blood pressure in hemodialysis patients. We should prevent and manage hypertension carefully by adjusting antihypertensive drugs and dry weight in renal cell carcinoma patients.
恶性肿瘤是透析患者死亡的主要原因。尽管包括酪氨酸激酶抑制剂在内的分子靶向抗癌药物被用于晚期肾细胞癌的治疗,但关于其在透析患者中的有效性和安全性的报道却很少。2010年至2013年在我院接受治疗的肾细胞癌透析患者参与了本研究。13例患者接受酪氨酸激酶抑制剂治疗,15例患者仅接受手术治疗(对照组)。治疗期间,酪氨酸激酶抑制剂组的血压变化和干体重减轻比对照组更明显。与对照组相比,酪氨酸激酶抑制剂组需要更强化的高血压管理。酪氨酸激酶抑制剂治疗肾细胞癌会使血液透析患者血压升高。我们应该通过调整抗高血压药物和肾细胞癌患者的干体重来仔细预防和管理高血压。