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癌症合并急性肾损伤患者的肾脏替代治疗(综述)

Renal replacement therapy in cancer patients with acute kidney injury (Review).

作者信息

Lupuşoru Mircea, Lupuşoru Gabriela, Ailincăi Ioana, Frățilă Georgiana, Andronesi Andreea, Micu Elena, Banu Mihaela, Costea Radu, Ismail Gener

机构信息

Department of Physiology 1, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Department of Nephrology, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania.

出版信息

Exp Ther Med. 2021 Aug;22(2):864. doi: 10.3892/etm.2021.10296. Epub 2021 Jun 11.

Abstract

Cancer patients are at high risk for developing acute kidney injury (AKI), which is associated with increased morbidity and mortality in these patients. Despite the progress made in understanding the pathogenic mechanisms and etiology of AKI in these patients, the main prevention consists of avoiding medication and nephrotoxic agents such as non-steroidal anti-inflammatory drugs, contrast agents used in medical imaging and modulation of chemotherapy regimens; when prophylactic measures are overcome and renal impairment becomes unresponsive to treatment, renal replacement therapy (RRT) is required. There are several methods of RRT that can be utilized for patients with malignancies and acute renal impairment; the choice of treatment being based on the patient characteristics. The aim of this article is to review the literature data regarding the epidemiology and management of AKI in cancer patients, the extracorporeal techniques used, choice of the appropriate therapy and the optimal time of initiation, and also the dose-prognosis relationship.

摘要

癌症患者发生急性肾损伤(AKI)的风险很高,这与这些患者发病率和死亡率的增加相关。尽管在了解这些患者AKI的发病机制和病因方面取得了进展,但主要预防措施包括避免使用药物和肾毒性药物,如非甾体类抗炎药、医学成像中使用的造影剂以及调整化疗方案;当预防措施无效且肾功能损害对治疗无反应时,则需要进行肾脏替代治疗(RRT)。有几种RRT方法可用于患有恶性肿瘤和急性肾功能损害的患者;治疗方法的选择基于患者的特征。本文的目的是综述有关癌症患者AKI的流行病学和管理、所使用的体外技术、合适治疗方法的选择和最佳启动时间,以及剂量-预后关系的文献数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ba5/8220659/2cfd7e4d546c/etm-22-02-10296-g00.jpg

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