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恶性肿瘤相关性肾脏病概述

Author
Colm C Magee, MD, MPH, FRCPI
Section Editor
Gary C Curhan, MD, ScD
Deputy Editor
John P Forman, MD, MSc
Translators
郑振峰, 副主任医师

引言

恶性肿瘤或其治疗可导致多种肾脏病[1]。急性和慢性肾脏病及电解质异常最为常见，但也可发生肾病综合征、孤立性蛋白尿及其他综合征。

本专题将总结影响癌症患者的主要肾脏和电解质问题，并指导读者在必要时查阅其他专题中的更详细讨论。

癌症患者的急性和慢性肾脏病

癌症患者的肾功能损害通常是多因素的。然而，将此类患者的肾损伤原因分为3大类有所帮助，即肾前性、肾性及肾后性[1]。

肾前性损伤 — 容量不足是癌症患者中的一个常见并发症，通常由化疗相关的呕吐和腹泻(常联合液体摄入不足)引起。此外，恶性肿瘤相关性高钙血症可能加重低血容量。 (参见“高钙血症的临床表现”，关于‘肾功能不全’一节)

癌症患者使用的药物可能导致肾前性损伤。例如，白细胞介素-2可引起毛细血管渗漏综合征，导致有效循环血容量减少。用于治疗癌症疼痛的非甾体类抗炎药可能促使有效循环血容量减少的患者发生急性肾损伤。 (参见“肾细胞癌的免疫治疗”和“非甾体类抗炎药：急性肾损伤(急性肾衰竭)”，关于‘急性肾损伤的机制’一节)

                       

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Literature review current through: 2017-06 . | This topic last updated: 2017-05-04.
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