相关实验视频
Updated: Jul 16, 2025
08:50
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
16.3K
年轻成年人功能受损和主要心血管事件
Junayd Hussain1, Haris Imsirovic2, Mark Canney3
1School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; ICES, Ottawa, Ontario, Canada.
Journal of the American College of Cardiology
|September 20, 2023
概括
根据估计的膜过率 (eGFR) 显示,功能下临床下降低于预期年龄值,在年轻人中增加心血管疾病的风险. 早期检测和干预对于管理这种日益严重的健康问题至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 公共卫生 公共卫生
背景情况:
- 心血管疾病 (CV) 在年轻成年人 (18-39岁) 中正在增加.
- 在这个人群中,亚临床功能下降 (EGFR低于预期年龄值) 与心血管风险升高之间的关联尚不清楚.
- 亚临床功能下降被定义为估计的球过率 (eGFR) 超过慢性病值,但低于预期的年龄水平.
研究的目的:
- 研究年轻成年人EGFR亚临床降低和主要心血管不良事件 (MACE) 之间的特定年龄关系.
- 检查亚临床eGFR降低与MACE加心力衰竭 (MACE+) 之间的关联.
主要方法:
- 追溯队列研究涉及870万个人,其中3600万年龄在18-39岁之间,使用加拿大省级健康数据 (2008-2021年).
- 考克斯模型分析了被分类的eGFR (50-120毫升/分钟/1.73米2) 与MACE和MACE+的关联.
- 分析根据年龄组进行了分层:18-39岁,40-49岁和50-65岁.
主要成果:
- 在年轻成年人中,观察到MACE和MACE+风险逐步增加,从EGFR<80mL/min/1.73m2开始.
- 对于MACE,风险比 (HR) 为1.31 (95% CI: 1.27-1.40) 在18-30岁之间,EGFR为70-79毫升/分钟/1.73米2.
- 这些关联在MACE组件和灵敏度分析中保持一致,包括那些考虑到以前的心血管疾病,白色素尿和重复的eGFR测量.
结论:
- 低于预期年龄水平的EGFR临床下降与年轻成年人中MACE和MACE+风险增加有关.
- 适合年龄的风险分层对于患有功能减弱的年轻人来说是必要的.
- 应考虑对这一群体进行主动监测和及时干预策略.
相关概念视频
01:17Factors Affecting Renal Clearance: Renal Impairment
119
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
119
01:20Exercise and Cardiovascular Response
856
Exercise significantly impacts cardiovascular response, which is crucial for understanding patient health and designing effective treatment plans.
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
856
01:24Chronic Kidney Disease II: Clinical Manifestations
29
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
29
01:11Renal Failure: Dose Adjustments
115
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
115
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
460
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...
460
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
34
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...
34