Department of Nephrology, Dialysis, and Internal Medicine, Medical University of Warsaw, Poland.
Second Propaedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Greece.
Kidney Int. 2020 Dec;98(6):1407-1418. doi: 10.1016/j.kint.2020.07.012.
The bidirectional relationship between cancer and chronic kidney disease (CKD) is complex. Patients with cancer, particularly those with hematological malignancies such as multiple myeloma and lymphoma, are at increased risk of developing acute kidney injury and CKD. On the other hand, emerging evidence from large observational registry analyses have consistently shown that cancer risk is increased by at least 2- to 3-fold in kidney transplant recipients, and the observed increased risk occurs not only in those who have received kidney transplants but also in those on dialysis and with mild- to moderate-stage CKD. The interactions between cancer and CKD have raised major therapeutic and clinical challenges in the management of these patients. Given the magnitude of the problem and uncertainties, and current controversies within the existing evidence, Kidney Disease: Improving Global Outcomes (KDIGO) assembled a global panel of multidisciplinary clinical and scientific expertise for a controversies conference on onco-nephrology to identify key management issues in nephrology relevant to patients with malignancy. This report covers the discussed controversies in kidney disease in hematological malignancies, as well as cancer after kidney transplantation. An overview of future research priorities is also discussed.
癌症和慢性肾脏病（CKD）之间的双向关系很复杂。患有癌症的患者，尤其是多发性骨髓瘤和淋巴瘤等血液系统恶性肿瘤患者，发生急性肾损伤和 CKD 的风险增加。另一方面，来自大型观察性登记分析的新证据一致表明，肾移植受者的癌症风险至少增加 2 至 3 倍，并且观察到的风险增加不仅发生在接受肾移植的患者中，也发生在透析和轻度至中度 CKD 的患者中。癌症和 CKD 之间的相互作用在这些患者的治疗和临床管理方面提出了重大的治疗和临床挑战。鉴于问题的严重性和不确定性，以及现有证据中的争议，肾脏病：改善全球预后组织（KDIGO）召集了一个全球多学科临床和科学专家小组，就肿瘤肾脏病学举行了一次争议会议，以确定与恶性肿瘤患者相关的肾脏病学管理方面的关键问题。本报告涵盖了血液系统恶性肿瘤中肾脏疾病以及肾移植后的癌症相关的讨论争议。还讨论了未来研究重点的概述。
