心血管疾患患者の慢性腎臓病に対するガイドライン指向の心血管保護療法の使用の傾向: 2つの横断スナップショット (HECMOS IとII) の現実世界データ
PubMedで要約を見る
まとめ
この要約は機械生成です。ギリシャの心臓病患者では,2年間でナトリウム・グルコース・コトランスポーター-2 阻害剤 (SGLT2i) の使用が倍増したが,ガイドラインに準じた治療は依然として未使用である. これは,慢性腎疾患の管理のためにSGLT2阻害剤とフィネレノンの実用化改善の必要性を強調しています.
科学分野
- 心臓病科
- 腎臓科
- 薬理学について
背景
- 慢性腎臓病 (CKD) は世界人口の10%に感染し,心血管疾患のリスクを高めています.
- レニン- 血管新生系阻害剤 (RASi) は標準的ですが,ナトリウム- グルコースコトランスポーター-2阻害剤 (SGLT2i) とフィネレノンにはレノ保護効果があります.
研究 の 目的
- ギリシャの心肺神経疾患患者の実際のガイドラインによる医療療法 (GDMT) を評価する.
- SGLT2iとフィネレノンの処方パターンに影響を与える要因を特定する.
主な方法
- ギリシャの心臓病患者のデータを集めたHellenic Cardiorenal Morbidity Snapshots (HECMOS 1と2) は,ギリシャの心臓病患者のデータを集めた.
- 薬剤と併発症のデータは自己報告とチャートレビューによって収集されました.
- 多変量ロジスティック回帰は,SGLT2iの使用の予測要因を特定しました.
主要な成果
- HECMOS 1と2では,CKDの罹患率は26~27%でした.
- HECMOS 1と2の間,SGLT2iの使用は15%から30.4%に増加しました.
- 糖尿病と心不全はSGLT2iの使用を予測し,フィネレノンの使用は低い (1. 7%),RASiの使用は安定した (約. 42%) でした.
結論
- SGLT2iは,CKDおよび心血管疾患の患者での使用が著しく増加し,GDMTの実施の進展を示しています.
- SGLT2iやフィネレノンのような病気を修正する治療法の最適化されていない使用が続いている.
- 心臓病患者の最適なケアのために,実際の臨床実務のさらなる改善が必要である.
関連する概念動画
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
Renal clearance is a crucial parameter in pharmacokinetics that quantifies the rate at which the kidneys excrete a drug. It represents a constant fraction of the central volume of distribution containing the drug that the kidney eliminates per unit of time.
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...

