在瑞典,与与酸使用相关的结局的绝对和相对风险
Alessandro Bosi1, Catherine M Clase2, Laura Ceriani1,3
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
JAMA network open
|July 7, 2023
概括
与酸相比,治疗双相情感障碍的疗法显示,病进展和急性损伤的风险与酸相似. 然而,升高的含量显著增加了这些风险,突显了需要仔细监测的必要性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 精神病学是一种精神病学.
- 临床药理学 临床药理学
背景情况:
- 是对双相情感障碍的关键治疗方法,但其潜在的毒性影响仍在争论中.
- 关于对双相情感障碍患者对脏的影响的先前研究产生了相互矛盾的结果.
研究的目的:
- 为了比较慢性病 (CKD) 进展和急性损伤 (AKI) 的风险,在开始与酸治疗的患者之间.
- 为了检查累积暴露,血清水平和结局之间的关联.
主要方法:
- 采用了新用户主动比较者队列研究设计.
- 用治疗权重的逆概率来控制来自瑞典斯德哥尔摩 (2006-2019) 的例行医疗数据中的混.
- 开始使用或氨酸的患者 (n=10,946) 被随访了平均4.5年.
主要成果:
- 与酸相比,的开始与CKD进展 (HR,1.11) 或AKI (HR,0.88) 的风险增加无关.
- 慢性病的绝对10年风险低且相似 (8.4%,酸8.2%).
- 血清水平升高 (>1.0 mmol/L) 与CKD进展 (HR,2.86) 和AKI (HR,3.51) 的风险显著增加有关.
结论:
- 虽然和氨酸对脏不良结果的绝对风险很低,但水平升高具有显著的风险.
- 密切监测血清水平和剂量调整至关重要,以减轻双相情感障碍患者的脏风险.
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