Schweitzer Lorne, Miko Benjamin A, Pereira Marcus R
Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA.
Kidney Int Rep. 2024 Apr 25;9(8):2337-2352. doi: 10.1016/j.ekir.2024.04.043. eCollection 2024 Aug.
Immune-mediated renal diseases are a diverse group of disorders caused by antibody, complement, or cell-mediated autosensitization. Although these diseases predispose to infection on their own, a growing array of traditional and newer, more targeted immunosuppressant medications are used to treat these diseases. By understanding their mechanisms of action and the infections associated with suppression of each arm of the immune system, nephrologists can better anticipate these risks and effectively prevent and recognize opportunistic infections. Focusing specifically on nonkidney transplant recipients, this review discusses the infections that can be associated with each of the commonly used immunosuppressants by nephrologists and suggest interventions to prevent infectious complications in patients with immune-mediated renal disease.
免疫介导的肾脏疾病是由抗体、补体或细胞介导的自身致敏引起的一组多样的病症。尽管这些疾病本身易引发感染,但越来越多的传统及更新的、更具针对性的免疫抑制药物被用于治疗这些疾病。通过了解其作用机制以及与免疫系统各部分抑制相关的感染,肾病学家能够更好地预测这些风险,并有效预防和识别机会性感染。本综述特别针对非肾移植受者,讨论了肾病学家常用的每种免疫抑制剂可能相关的感染,并提出了预防免疫介导性肾病患者感染并发症的干预措施。