Wang Li-Yan, Wang Jia-Ni, Diao Zong-Li, Guan Yi-Ming, Liu Wen-Hu
Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
J Cancer. 2020 May 22;11(16):4700-4708. doi: 10.7150/jca.45382. eCollection 2020.
With rapid progress in cancer diagnosis and treatment in the last two decades, outcomes in oncological patients have improved significantly. However, the incidence of acute kidney injury (AKI) in this population has also increased significantly. AKI complicates many aspects of patients' care and adversely affects their prognoses; thus, accurately diagnosing the risk factors for AKI ensures appropriate management. AKI may be caused by pre-renal, intrinsic renal, and post-renal reasons, as well as for combined reasons. This review summarizes the potential etiologies of AKI according to the three classifications. For each underlying cause of AKI, the cancer itself and/or cancer treatment may contribute to a patient developing AKI. Therefore, we present disease- and treatment-related factors for each cause category, with special focus on immune checkpoint inhibitors, which are being used increasingly more often. It is important for nephrology services to be knowledgeable to provide the best level of care.
在过去二十年中，随着癌症诊断和治疗的迅速进展，肿瘤患者的治疗结果有了显著改善。然而，这一人群中急性肾损伤（AKI）的发生率也显著增加。AKI使患者护理的许多方面变得复杂，并对其预后产生不利影响；因此，准确诊断AKI的危险因素可确保进行适当的管理。AKI可能由肾前性、肾性和肾后性原因以及混合原因引起。本综述根据这三种分类总结了AKI的潜在病因。对于AKI的每种潜在病因，癌症本身和/或癌症治疗都可能促使患者发生AKI。因此，我们针对每个病因类别介绍了与疾病和治疗相关的因素，特别关注越来越频繁使用的免疫检查点抑制剂。肾脏科服务部门了解相关知识以提供最佳护理水平非常重要。
