Cosmai Laura, Porta Camillo, Foramitti Marina, Perrone Valentina, Mollica Ludovica, Gallieni Maurizio, Capasso Giovambattista
Onco-Nephrology Outpatient Clinic, Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, Fatebenefratelli Hospital, Milan, Italy.
Department of Biomedical Sciences and Human Oncology, University of Bari 'A. Moro', Bari, Italy.
Clin Kidney J. 2020 Nov 28;14(1):70-83. doi: 10.1093/ckj/sfaa127. eCollection 2021 Jan.
Acute kidney injury (AKI) is a common complication of cancer that occurs in up to 50% of neoplastic patients during the natural history of their disease; furthermore, it has a huge impact on key outcomes such as overall prognosis, length of hospitalization and costs. AKI in cancer patients has different causes, either patient-, tumour- or treatment-related. Patient-related risk factors for AKI are the same as in the general population, whereas tumour-related risk factors are represented by compression, obstruction, direct kidney infiltration from the tumour as well by precipitation, aggregation, crystallization or misfolding of paraprotein (as in the case of multiple myeloma). Finally, treatment-related risk factors are the most common observed in clinical practice and may present also with the feature of tumour lysis syndrome or thrombotic microangiopathies. In the absence of validated biomarkers, a multidisciplinary clinical approach that incorporates adequate assessment, use of appropriate preventive measures and early intervention is essential to reduce the incidence of this life-threatening condition in cancer patients.
急性肾损伤（AKI）是癌症常见的并发症，在肿瘤患者疾病自然史中发生率高达50%；此外，它对总体预后、住院时间和费用等关键结局有巨大影响。癌症患者发生AKI有不同原因，包括患者相关、肿瘤相关或治疗相关。患者相关的AKI危险因素与普通人群相同，而肿瘤相关危险因素表现为压迫、梗阻、肿瘤直接侵犯肾脏，以及副蛋白沉淀、聚集、结晶或错误折叠（如多发性骨髓瘤的情况）。最后，治疗相关危险因素是临床实践中最常见的，也可能表现为肿瘤溶解综合征或血栓性微血管病的特征。在缺乏经过验证的生物标志物的情况下，采用多学科临床方法，包括进行充分评估、采取适当预防措施和早期干预，对于降低癌症患者发生这种危及生命状况的发生率至关重要。
