《抗肿瘤药物治疗期间肾损伤管理临床实践指南(2022)》解读(六):透析和肾移植术后患者的抗肿瘤药物治疗

Interpretation of Clinical Practice Guidelines for Management of Kidney Injury During Anticancer Drug Therapy 2022(Ⅵ):anticancer drug therapy for patients on dialysis and after kidney trans⁃plantation

随着透析治疗的普及和肾移植手术技术的不断突破,终末期肾病患者的存活期延长,恶性肿瘤已成为透析和肾移植患者住院和死亡的主要原因之一。由于透析患者药物代谢动力学的特殊性和肾移植患者术后的长期免疫抑制维持治疗,这些患者在应用抗肿瘤药物治疗时需要平衡和考量多方面问题。日本肾脏病学会、日本临床肿瘤学会、日本医学肿瘤学会和日本肾脏病药物治疗学会共同制订的《抗肿瘤药物治疗期间肾损伤管理临床实践指南(2022)》的第2章比较系统地回答了透析和肾移植术后患者抗肿瘤药物治疗的诸多临床问题。本文针对该部分内容进行解读,为我国透析和肾移植术后肿瘤患者的治疗提供参考。

With the spread of hemodialysis therapy and the continuous breakthrough of kidney transplantation technology,the survival period of patients with end⁃stage renal disease is prolonged,and malignant tumor has become one of the main causes for hospitalization and death of patients on hemodialysis and undergoing kidney transplantation.Due to the particularity of pharmacokinetics in patients on dialysis and the long⁃term maintenance immunosuppressive therapy in kidney transplant patients,many aspects need to be considered and balanced in these patients when they need anti⁃tumor drug treatments.The Japanese Society of Nephrology,Japan Society of Clinical Oncology,Japanese Society of Medical Oncology,and Japanese Society of Nephrology and Pharmacotherapy have jointly formulated Clinical Practice Guidelines for Management of Kidney Injury During Anticancer Drug Therapy 2022,and systematically answers many clinical questions about anticancer drug therapy in patients on hemodialysis and underwent kidney trans⁃plantation in the second chapter.This article interprets this part to provide references for the anti-tumor drug treatments of patients on dialysis and after kidney transplantation in China.