肾移植术后慢性病防治管理

Management of chronic diseases after kidney transplantation

  • 摘要: 肾移植作为终末期肾病最理想的治疗方式,显著提升了患者的生存率和生活质量。然而,随着术后生存期的逐渐延长,慢性病已成为影响肾移植长期结局的主要障碍。这些慢性病发生率高、受累多器官且显著影响预后,核心驱动因素主要与长期免疫抑制治疗相关。本文系统论述了肾移植术后常见慢性病(主要包括慢性移植物功能障碍、心血管疾病、感染、恶性肿瘤、骨代谢紊乱等)的发生机制、防治策略与分类管理。同时,探讨精准医学、新型免疫调节剂、远程管理等未来发展方向,强调以“多学科协作+个体化治疗+持续监测”为核心的综合管理模式,以实现对肾移植受者慢性病的长期、系统、动态防治。

     

    Abstract: Kidney transplantation is the most ideal treatment method for end-stage renal disease, significantly improving the survival rate and quality of life of patients. However, as the postoperative survival period gradually lengthens, chronic diseases have become the main obstacle affecting the long-term outcome of kidney transplantation. These chronic diseases have a high incidence, involve multiple organs and significantly impact prognosis. The core driving factors are mainly related to long-term immunosuppressive therapy. This article systematically discusses the occurrence mechanisms, prevention and treatment strategies, and classification management of common chronic diseases after kidney transplantation (mainly including chronic graft dysfunction, cardiovascular diseases, infections, malignant tumors, bone metabolism disorders, etc.). At the same time, it explores future development directions such as precision medicine, new immune modulators and remote management, emphasizing a comprehensive management model centered on "multidisciplinary collaboration + individualized treatment + continuous monitoring" to achieve long-term, systematic, and dynamic prevention and treatment of chronic diseases for kidney transplant recipients.

     

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