Kaynar Kubra, Misir Buse, Ataberk Huri Cihan, Mungan Sevdegül, Çobanoğlu Ümit
Department of Nephrology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkiye.
Faculty of Medicine, İstanbul Medipol University, İstanbul, Turkiye.
Pan Afr Med J. 2025 Jun 9;51:35. doi: 10.11604/pamj.2025.51.35.47605. eCollection 2025.
Kidneys are functionally affected by the diseases of other organs. Here, we present an elderly predialysis patient with a functioning kidney for 10 years of nephrological follow-up despite many comorbidities. A 75-year-old male patient with a medical history of hypertension for 15 years and 60 pack years of cigarette smoking, was diagnosed as muscle invasive bladder cancer (MIBC) and synchronous centrally located clear cell renal cell carcinoma (ccRCC) in the left kidney. At admission, the patient had an Estimated Glomerular Filtration Rate (eGFR) (CKD-EPI-cre) of 54mL/min/1.73m, after left nephrectomy eGFR of the patient decreased to 35 mL/min/1.73m. After ten years of follow-up, the patient's right kidney had been functional with a eGFR of 24 mL/min/1.73m despite radical cystectomy with urinary diversion, radical nephrectomy, heavy smoking, [cardiorenal syndrome, chronic obstructive pulmonary disease, and hypertension. It is well known that comorbidities such as hypertension, smoking, cancers, infections, pulmonary and heart diseases contribute to irreversible kidney damage and are additive to decreasing kidney function. Appropriate and early diagnosis and treatment of these comorbidities permit healthy aging of the kidneys without the need for dialysis.
肾脏功能会受到其他器官疾病的影响。在此，我们介绍一位老年透析前患者，尽管存在多种合并症，但在肾脏病随访期间其一个肾脏功能良好达10年。一名75岁男性患者，有15年高血压病史，吸烟史60包年，被诊断为肌层浸润性膀胱癌（MIBC），同时左肾患有中心型透明细胞肾细胞癌（ccRCC）。入院时，患者的估算肾小球滤过率（eGFR）（CKD-EPI-cre）为54mL/min/1.73m²，左肾切除术后患者的eGFR降至35 mL/min/1.73m²。经过十年的随访，尽管患者接受了根治性膀胱切除术加尿流改道、根治性肾切除术、大量吸烟、[心肾综合征、慢性阻塞性肺疾病和高血压]，但其右肾仍保持功能，eGFR为24 mL/min/1.73m²。众所周知，高血压、吸烟、癌症、感染、肺部和心脏疾病等合并症会导致不可逆的肾损伤，并加剧肾功能下降。对这些合并症进行恰当的早期诊断和治疗，可使肾脏健康老化，无需进行透析。
