Pittappilly Matthew, Sharshir Mohammed, Paramesh Anil
Department of Nephrology, Tulane Transplant Institute, East Jefferson Hospital, Tulane University School of Medicine, New Orleans, LA 70112, USA.
Department of Surgery, Tulane Transplant Institute, East Jefferson Hospital, Tulane University School of Medicine, New Orleans, LA 70112, USA.
Biomedicines. 2025 Apr 9;13(4):929. doi: 10.3390/biomedicines13040929.
Chronic allograft nephropathy is the leading cause of kidney allograft failure. Clinically, it is characterized by a progressive decline in kidney function, often in combination with proteinuria and hypertension. Histologically, interstitial fibrosis and tubular atrophy, along with features of glomerulosclerosis with occasional double contour appearance, arteriolar hyalinosis, and arteriosclerosis, are characteristic findings. The pathophysiology, though complex and incompletely understood, is thought to involve a sequence of immunologic and non-immunologic injuries eventually leading to tissue remodeling and scarring within the graft. The optimal strategy to prevent chronic allograft nephropathy is to minimize both immune- and non-immune-mediated graft injury.
慢性移植肾肾病是肾移植失败的主要原因。临床上，其特征为肾功能进行性下降，常伴有蛋白尿和高血压。组织学上，间质纤维化和肾小管萎缩，以及肾小球硬化的特征（偶尔可见双轨征）、小动脉玻璃样变性和动脉硬化，是其典型表现。尽管其病理生理学复杂且尚未完全明确，但认为涉及一系列免疫和非免疫损伤，最终导致移植物内组织重塑和瘢痕形成。预防慢性移植肾肾病的最佳策略是尽量减少免疫和非免疫介导的移植物损伤。
