Attieh Rose Mary, Begum Farhana, Chitty David, Izzedine Hassan, Jhaveri Kenar D
Division of Kidney Diseases and Hypertension, Department of Medicine, Glomerular Center at Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York.
Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York.
Kidney Med. 2023 Dec 5;6(2):100769. doi: 10.1016/j.xkme.2023.100769. eCollection 2024 Feb.
Chronic myelomonocytic leukemia (CMML) is a hematologic malignancy affecting the bone marrow and resulting in peripheral blood monocytosis. Kidney and urinary tract involvement is common and can present dramatically with life-threatening consequences. Kidney involvement can be the result of direct or indirect mechanisms, including prerenal azotemia, glomerular disease, tubulointerstitial involvement, and renovascular disorders. Urinary tract involvement, electrolyte and acid-base disorders, as well as nephrotoxicity from treatment of the disorder can also occur. Given this multifactorial pathogenesis involving several mechanisms concomitantly, nephrologists must exercise heightened awareness and maintain a low threshold for kidney biopsy. There is a pressing need for future research endeavors to elucidate and target the manifestations of CMML that involve the kidneys with the ultimate goal of augmenting overall prognosis and therapeutic outcomes.
慢性粒单核细胞白血病（CMML）是一种影响骨髓并导致外周血单核细胞增多的血液系统恶性肿瘤。肾脏和泌尿系统受累很常见，可能会急剧出现并导致危及生命的后果。肾脏受累可能是直接或间接机制导致的，包括肾前性氮质血症、肾小球疾病、肾小管间质受累和肾血管疾病。泌尿系统受累、电解质和酸碱紊乱以及该疾病治疗引起的肾毒性也可能发生。鉴于这种涉及多种机制的多因素发病机制，肾脏病学家必须提高警惕，对肾脏活检保持较低的阈值。迫切需要未来的研究努力来阐明和针对CMML累及肾脏的表现，最终目标是改善总体预后和治疗效果。
