Onco-Nephrology: Cancer, chemotherapy and kidney.
Onco-Nephrology: Cancer, chemotherapy and kidney.
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DOI：
10.1016/j.nefro.2018.10.016
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发表时间：
2019-09-01
期刊：
影响因子：
2.6
通讯作者：
Torregrosa, Isidro
中科院分区：
文献类型：
--
作者：
de Francisco, Angel L M;Macia, Manuel;Torregrosa, Isidro
慢性肾脏疾病、癌症和血液病有着相互影响的共同领域。癌症可以通过肾小球病变或药物或辐射的毒性作用影响肾脏，导致急性（血栓性微血管病、急性肾损伤、间质性肾病等）或慢性过程（因肾切除术后CKD恶化）。癌症、间质纤维化、水电解质紊乱）。另一方面，需要通过透析进行肾脏替代治疗的患者，特别是需要进行肾脏移植的患者，由于其产生的免疫抑制情况，癌症发病的风险很高。除了传统的化疗外，还开发了创新的治疗方法：针对生长因子及其受体的靶向药物;抗血管生成药物;免疫调节蛋白;细胞周期调节剂;和酶抑制剂。也已经开发了其他免疫方法，例如疫苗，过继细胞疗法（CAR T细胞）或抗体的开发。所有这些治疗进展都将改善癌症和血液病的预后，但它们并不能避免继发性肾脏问题。肿瘤肾病学已经是西班牙肾病学会的一个重要领域，有大量的相互咨询。肾病学家需要更好地了解癌症生物学及其治疗的快速发展领域，以便成为癌症护理团队的重要成员，并提供最好的肾脏护理。
Chronic kidney disease (CKD), cancer and haematological diseases share areas of reciprocal influence. Cancer can affect the kidney either as glomerular lesions or as a result of the toxic effects of medication or radiation with acute (thrombotic microangiopathy, acute kidney injury, interstitial nephropathies among others) or chronic processes (worsening of CKD after nephrectomy due to renal cancer, interstitial fibrosis, hydroelectrolytic disorders). On the other hand, patients who require renal replacement therapy with dialysis and particularly with kidney transplantation are at high risk of onset of cancer due to the immunosuppression situation that they generate. In addition to conventional chemotherapy, innovative treatments have been developed: target agents against growth factors and their receptor; anti-angiogenic drugs; immunoregulatory proteins; cell cycle regulators; and enzyme inhibitors. Other immunotherapeutic approaches have also been developed, such as vaccines, adoptive cell therapy (CAR T cells) or development of antibodies. All these therapeutic advances will improve the outcomes against cancer and haematological diseases, but they are not free from secondary renal problems. Onco-Nephrology is already an important area for the Spanish Society of Nephrology with a large number of inter-consultations. Nephrologists need a better understanding of rapidly evolving areas of cancer biology and its treatment in order to become valued members of the cancer care team and to provide the best nephrology care possible.