Glomerular diseases and cancer: evaluation of underlying malignancy.
Glomerular diseases and cancer: evaluation of underlying malignancy.
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DOI：
10.1007/s40620-015-0234-9
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发表时间：
2016-04
影响因子：
3.4
通讯作者：
Ponticelli C
中科院分区：
文献类型：
--
作者：
Pani A;Porta C;Cosmai L;Melis P;Floris M;Piras D;Gallieni M;Rosner M;Ponticelli C
肿瘤肾脏学是一门新兴的医学分支学科，专注于癌症和肾脏疾病之间的众多相互联系。恶性肿瘤患者通常会出现肾脏问题，包括急性肾损伤、肿瘤溶解综合征、体液和电解质紊乱以及慢性肾脏疾病，通常是抗癌治疗的结果。相反，一些肾小球病、肾小管病和血管性肾病可以早期提示潜在癌症的存在。此外，免疫抑制药物，特别是细胞毒性药物和钙调磷酸酶抑制剂的施用可能强烈损害免疫应答，增加癌症的风险。这篇综述文章的目的是：（i）讨论副肿瘤性肾小球疾病，（ii）审查癌症作为免疫抑制剂用于治疗肾小球疾病的不良反应，（iii）在缺乏国际批准的指南，提出了一个筛选计划的基础上，专家意见，旨在指导肾脏病学家在其临床实践中早期发现恶性肿瘤。
Onconephrology is an emerging medical subspecialty focused on the numerous interconnections between cancer and kidney diseases. Patient with malignancies commonly experience kidney problems including acute kidney injury, tumor lysis syndrome, fluid and electrolyte disorders and chronic kidney disease, often as a consequence of the anti-cancer treatment. Conversely, a number of glomerulopathies, tubulopathies and vascular renal diseases can early signal the presence of an underlying cancer. Furthermore, the administration of immunosuppressive drugs, especially cytotoxic drugs and calcineurin inhibitors, may strongly impair the immune response increasing the risk of cancer. The objective of this review article is to: (i) discuss paraneoplastic glomerular disease, (ii) review cancer as an adverse effect of immunosuppressive agents used to treat glomerulopathies, and (iii) in the absence of international approved guidelines, propose a screening program based on expert opinion aimed at guiding nephrologists to early detect malignancies during their clinical practice.