Vol. 12. Núm. 82.
Páginas 4831-4839 (Junio 2019)

Actualización
Afectación renal en las enfermedades infecciosas y neoformativas

Kidney impairment in infectious diseases and neoplasms

P. Martínez MiguelN. Sanz Martín
Doi : https://10.1016/j.med.2019.06.013
Opciones
Resumen

Las enfermedades infecciosas y neoformativas pueden provocar un amplio espectro de patologías con afectación renal. El objetivo de esta actualización es evaluar las principales patologías renales asociadas con infecciones, así como las principales formas de afectación renal en las neoplasias, con especial mención al daño renal en el contexto de una gammapatía monoclonal, bien sea en el seno de un proceso maligno o no. Respecto a los procesos infecciosos asociados a la enfermedad renal, cabe destacar el cambio epidemiológico que los nuevos tratamientos farmacológicos están provocando. En las últimas décadas, se ha modificado el perfil de las glomerulonefritis asociadas a infecciones bacterianas, así como las formas de afectación renal asociadas al virus de la inmunodeficiencia humana. La vacuna del virus de la hepatitis B VHB ha disminuido la frecuencia de la patología renal asociada con esta infección, algo que es esperable que ocurra con el virus de la hepatitis C y los nuevos antivirales de acción directa. La profundización en el conocimiento de las discrasias de células plasmáticas y sus mecanismos patogénicos a nivel renal, junto con los avances terapéuticos, también están mejorando el pronóstico de los pacientes que presentan estas enfermedades.

Palabras clave
Glomerulonefritis
Infecciones
Neoplasias
Gammapatía monoclonal
Abstract

Infectious diseases and neoplasms can cause a broad range of renal pathologies. The aim of the current update is to evaluate the most important renal disorders related with infections processes as well as to describe the main forms of renal impairment in neoplasms, focusing on monoclonal gammopathy, malignant or not, of renal significance. Regarding infectious processes, it is important to take into account the epidemiological changes originated by the new pharmacological treatments. In last decades, epidemiological profile of both glomerulonephritis associated with bacterial infections and HIV-associated renal diseases have changed. The frequency of renal pathology associated with hepatitis B virus has changed with its vaccination. Something similar is expected to happen with hepatitis C virus and the new direct-acting antivirals. The deeper knowledge of plasma cell dyscrasias and pathogenic mechanisms in the kidney, with therapeutic advances, are also improving the prognosis of patients with these diseases.

Keywords
Glomerulonephritis
Infectious
Neoplasms
Monoclonal gammopathy

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