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抗癌疗法的肾毒性效应:第 34 届急性疾病质量倡议工作组共识报告

英文原题:The nephrotoxic effects of anti-cancer therapies: consensus report of the 34th Acute Disease Quality Initiative workgroup.

查看英文原题

The nephrotoxic effects of anti-cancer therapies: consensus report of the 34th Acute Disease Quality Initiative workgroup.

PubMed 2025/12/08(内容时间) Nat Rev Nephrol Q1 · IF 46.7(JCR 2025)

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中文摘要

在过去的几十年中,对癌症生物学理解的进步促进了高效常规化疗、作用于对癌症生长至关重要的特定通路的靶向治疗、免疫基础治疗以及细胞治疗(如造血细胞移植和CAR-T 细胞治疗)的发展。

然而,这些疗法的肾毒性效应仍然构成重大挑战,在预防、诊断和管理这种肾毒性方面仍有许多未解问题。此外,对于急性肾损伤或慢性肾病患者以及接受肾脏替代治疗的患者,在肾功能评估和药物剂量方面缺乏共识和精确指导,限制了患者获得挽救生命的治疗机会并危及预后。在本共识声明中,我们提出了关于成人患者抗癌治疗肾毒性的预防、诊断和管理的指导,该指导是在第34届急性疾病质量倡议会议上制定的,该会议召集了肾脏病学、血液学、肿瘤学、肾脏病理学、重症监护、儿科护理和药理学领域的国际专家小组。

我们还确定了一个研究议程,重点关注预防和减轻抗癌治疗毒性、最大化肾毒性的早期检测以及为肾病患者实现最佳药物剂量,目标是推进癌症治疗并充分发挥这些突破性疗法的潜力。

展开英文摘要原文

In the past few decades, advances in understanding of cancer biology have led to the development of highly effective conventional chemotherapies, targeted therapies that act on specific pathways that are critical to cancer growth, immune-based therapies, and cellular therapies such as haematopoietic cell transplantation and chimeric antigen receptor T cell therapy.

However, the nephrotoxic effects of these therapies continue to pose substantial challenges, with many unanswered questions regarding the prevention, diagnosis and management of this nephrotoxicity.

Further, a lack of consensus and precise guidance on kidney function estimation and drug dosing for patients with acute kidney disease or chronic kidney disease and for patients receiving kidney replacement therapy limits access to life-saving therapies and jeopardizes outcomes.

In this Consensus Statement, we present guidance on the prevention, diagnosis and management of anticancer therapy nephrotoxicity for adult patients that was developed at the 34th Acute Disease Quality Initiative meeting, which convened an international panel of experts in nephrology, haematology, oncology, nephropathology, critical care, paediatric care and pharmacology.

We also define a research agenda focused on preventing and mitigating anticancer therapy toxicity, maximizing early detection of nephrotoxicity and enabling optimal drug dosing in patients with kidney disease, with the goal of advancing cancer care and fulfilling the potential of these ground-breaking treatments.

论文信息

作者
Renaghan AD、Ostermann M、Ronco C、Ballen K、Cosmai L、Fenoglio R、Floris M、Forni LG
单位
Division of Nephrology, University of Virginia Health System, Charlottesville, VA, USA. ajd9y@uvahealth.org.United States
文献类型
综述 · 共识声明
期刊
Nature reviews. Nephrology2026 Apr
原文标识
PubMed 41361704 · DOI 10.1038/s41581-025-01031-3