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移植肾后复发性肾小球疾病:诊断与治疗困境。

Recurrent Glomerular Disease after Kidney Transplantation: Diagnostic and Management Dilemmas.

机构信息

Renal Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

出版信息

Clin J Am Soc Nephrol. 2021 Nov;16(11):1730-1742. doi: 10.2215/CJN.00280121. Epub 2021 Oct 22.

Abstract

Recurrent glomerular disease after kidney transplant remains an important cause of allograft failure. Many of the different entities post-transplant still suffer from incomplete knowledge on pathophysiology, and therefore lack targeted and effective therapies. In this review, we focus on specific clinical dilemmas encountered by physicians in managing recurrent glomerular disease by highlighting new insights into the understanding and treatment of post-transplant focal segmental glomerulosclerosis, membranous nephropathy, atypical hemolytic uremic syndrome, C3 glomerulopathy, amyloid light-chain (AL) amyloidosis, and IgA nephropathy.

摘要

移植肾后复发性肾小球疾病仍然是导致移植物失功的重要原因。许多移植后出现的不同疾病仍然存在对其病理生理学认识不完整的问题,因此缺乏靶向和有效的治疗方法。在这篇综述中,我们通过强调对移植后局灶节段性肾小球硬化症、膜性肾病、非典型溶血尿毒综合征、C3 肾小球病、轻链(AL)淀粉样变性和 IgA 肾病的理解和治疗的新见解,重点介绍了医生在处理复发性肾小球疾病时遇到的具体临床难题。

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