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肾脏疾病与造血干细胞移植

Kidney Disease and Hematopoietic Stem Cell Transplantation.

作者信息

Renaghan Amanda DeMauro, Costa José Maximino, Esteves Alexandra

机构信息

Division of Nephrology, University of Virginia Health System, Charlottesville, Virginia.

Nephrology Department, Instituto Português de Oncologia do Porto, Porto, Portugal.

出版信息

Kidney360. 2025 Feb 1;6(2):317-330. doi: 10.34067/KID.0000000692. Epub 2025 Jan 9.

Abstract

Hematopoietic stem cell transplantation (HSCT) is a potentially curative therapy for patients with hematologic malignancies and certain solid tumors and nonmalignant hematologic conditions. Both AKI and CKD occur commonly after HSCT and are associated with significant morbidity and mortality. AKI and CKD in this setting may result from direct effects of the transplant or be caused by pretransplant bone marrow conditioning regimens and/or nephrotoxic agents administered in the post-transplant period. In this article, we review the epidemiology, risk factors, etiologies, pathophysiology, diagnosis, prevention, and treatment of post-HSCT AKI and CKD, with special attention to recent advances in this fast-moving and evolving field.

摘要

造血干细胞移植(HSCT)是一种对血液系统恶性肿瘤、某些实体瘤及非恶性血液系统疾病患者具有潜在治愈作用的治疗方法。急性肾损伤(AKI)和慢性肾脏病(CKD)在HSCT后均很常见,且与显著的发病率和死亡率相关。这种情况下的AKI和CKD可能是移植的直接影响所致,也可能是移植前骨髓预处理方案和/或移植后使用的肾毒性药物引起的。在本文中,我们综述了HSCT后AKI和CKD的流行病学、危险因素、病因、病理生理学、诊断、预防及治疗,特别关注这一快速发展领域的最新进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ed8/11882261/4357339fcfb9/kidney360-6-317-g001.jpg

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