Masuda Hiroshi
Department of Urology, Chiba Rosai Hospital, Chiba, Japan
Anticancer Res. 2023 Jan;43(1):305-309. doi: 10.21873/anticanres.16164.
Androgen deprivation therapy (ADT) is the major treatment for advanced prostate cancer (PCa). Although ADT has been shown to improve oncological outcomes against PCa, it can also induce various adverse events, such as loss of libido, gynecomastia, fatigue, hot flashes, anemia, obesity, insulin resistance, dyslipidemia, cardiovascular events, and acute kidney injury (AKI). ADT reduces testosterone levels; consequently, ADT may antagonize the vasodilatory effects of testosterone on renal blood vessels, which could negatively affect renal tubular function. However, the renal impairment due to ADT is transient; i.e., it improves after the discontinuation of ADT. The recovery of serum testosterone levels may contribute to the amelioration of renal impairment induced by ADT. Serum testosterone levels are probably implicated in these changes, but the mechanism has not been studied in detail. With regard to the preservation of renal function and the anti-cancer effect of PCa, intermittent ADT may be a useful treatment for PCa. This is a review of the recent reports on the mechanism, current status, and prevention of renal impairment induced by ADT; future prospects in this field are also discussed.
雄激素剥夺疗法（ADT）是晚期前列腺癌（PCa）的主要治疗方法。尽管ADT已被证明可改善针对PCa的肿瘤学结局，但它也可诱发各种不良事件，如性欲减退、男性乳房发育、疲劳、潮热、贫血、肥胖、胰岛素抵抗、血脂异常、心血管事件和急性肾损伤（AKI）。ADT会降低睾酮水平；因此，ADT可能会拮抗睾酮对肾血管的舒张作用，这可能会对肾小管功能产生负面影响。然而，ADT导致的肾功能损害是短暂的；也就是说，在停用ADT后会有所改善。血清睾酮水平的恢复可能有助于改善ADT引起的肾功能损害。血清睾酮水平可能与这些变化有关，但其机制尚未得到详细研究。关于肾功能的保留和PCa的抗癌作用，间歇性ADT可能是PCa的一种有效治疗方法。本文综述了近期关于ADT所致肾功能损害的机制、现状及预防的报道；还讨论了该领域的未来前景。
