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移植肾慢性损害（chronic allograft injury，CAI）一般在肾脏移植后的中长期阶段出现，导致移植肾脏功能逐渐下降，影响移植肾和受者的长期存活。CAI存在多种不同病因，可能相互交织，临床表现复杂，这些特点给CAI的诊断和治疗带来挑战。因此，如何有效应对CAI是肾脏移植领域中的重要临床问题。为了保护移植肾功能，提高移植肾长期存活率，中华医学会器官移植学分会发起并制订了《移植肾慢性损害临床诊疗指南（2023版）》，本指南系统总结CAI的病因、临床诊断和鉴别诊断、治疗策略、预后和随访方案，采用2009牛津大学证据分级与推荐意见强度分级标准，制定推荐强度和证据等级，为临床诊疗全过程提供参考。

Chronic allograft injury (CAI) typically occurs in the medium to long-term stage after kidney transplantation, resulting in a gradual deterioration of the transplanted kidney's function and affecting long-term survival of the grafts and recipients. CAI has multiple etiologies with varying injuries that may intertwine, leading to complex clinical manifestations. This poses challenges for diagnosing and treating CAI effectively, making it an important clinical issue in the field of kidney transplantation. To protect the function of the transplanted kidney and enhance its long-term survival rate, the Chinese Medical Association of Organ Transplantation Branch initiated the development of the "Guideline for the Clinical Diagnosis and Treatment of Chronic Injury of Transplanted Kidney (2023 edition) ". This guideline systematically summarizes CAI's etiologies, clinical diagnosis and differential diagnosis, treatment strategies, prognosis and follow-up plans while adhering to "Oxford University's 2009 Evidence Grading System" for recommendation strength grading standards. By establishing recommendation strength levels and evidence grades, this guideline provides guidance throughout all stages of clinical diagnosis and treatment.