Cachat F, Guignard J P
Service de pédiatrie, CHUV, Lausanne.
Rev Med Suisse Romande. 1996 Dec;116(12):985-93.
Nowadays more and more children survive after an intensive anti-tumoral therapy. The price to pay consists of numerous and relatively frequent long-term sequelae (secondary tumors, neuropsychological deficits, endocrine or cardiac damage). After chemotherapy, we sometimes observe renal side-effects, either tubular (metabolic acidosis, hypokalemia, hypomagnesemia, proteinuria, Fanconi syndrome, rickets) or glomerular (acute or chronic decreased GFR). These renal toxic side-effects are encountered especially after cisplatinum and ifosfamide, less frequently after carboplatin and cyclophosphamide. The pediatrician has to be aware of these toxic nephrologic side-effects, to look out for them and monitor carefully the renal function of all paediatric patients receiving these potentially nephrotoxic chemotherapies.
如今,越来越多的儿童在接受强化抗肿瘤治疗后存活下来。为此付出的代价是出现许多相对常见的长期后遗症(继发性肿瘤、神经心理缺陷、内分泌或心脏损伤)。化疗后,我们有时会观察到肾脏副作用,包括肾小管性(代谢性酸中毒、低钾血症、低镁血症、蛋白尿、范科尼综合征、佝偻病)或肾小球性(急性或慢性肾小球滤过率降低)。这些肾脏毒性副作用尤其在使用顺铂和异环磷酰胺后出现,在使用卡铂和环磷酰胺后出现的频率较低。儿科医生必须了解这些毒性肾脏副作用,留意它们,并仔细监测所有接受这些潜在肾毒性化疗的儿科患者的肾功能。