身体组成对老年患者功能估计的影响
Soyoko Kaburaki1,2, Shungo Imai3,4, Hitoshi Kashiwagi4
1Division of Pharmacy, Chiba University Hospital.
Biological & pharmaceutical bulletin
|November 1, 2023
概括
经过修改的柯克克罗夫特-高尔特 (CG) 方程改善了老年人肌素清除率 (CCr) 的估计. 该研究引入了一种新的多变量回归方程,以提高准确性,特别是在低白蛋白水平的老年患者中.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 老年病的医生 老年病的医生
- 临床化学 临床化学
背景情况:
- 传统的Cockcroft-Gault (CG) 方程被广泛用于估计肌素清除率 (CCr).
- 之前对修改过的CG方程的验证表明,在老年人群中,准确性有所提高.
- 在不同患者群体中,仍然需要更精确的CCr估计.
研究的目的:
- 在新数据集中验证对CCr估计的修改过的CG方程.
- 确定影响CCr估计准确性的因素.
- 开发和验证多变量线性回归 (MLR) 方程,以改善老年人中CCr估计.
主要方法:
- 修改后的CG方程与新数据集的验证.
- 统计分析以确定与估计偏差相关的因素,包括白蛋白水平.
- 单变量和多变量线性回归分析,包括身体组成参数 (细胞外水/总体水,体脂百分比).
主要成果:
- 修改后的CG方程提供了比传统CG方程更准确的CCr估计,特别是在65岁以上的患者中.
- 减少的白蛋白水平被确定为不充分估计的关键因素.
- 一种新的MLR方程,结合了人体成分,对老年患者,特别是那些低白蛋白患者,表现出很好的准确性.
结论:
- 修改后的CG方程为老年人提供了更好的CCr估计.
- 专水平和身体成分是准确估计CCr的关键因素.
- 一个拟议的流程图指导选择最合适的CCr估计方程 (CG,修改CG或MLR).
相关概念视频
01:17Factors Affecting Renal Clearance: Renal Impairment
101
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...
101
01:24Serum Studies: Renal Function Tests
9
Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.
9
01:11Renal Failure: Dose Adjustments
96
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...
96
01:28Chronic Kidney Disease III: Interprofessional Care
13
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...
13
01:29Bone Disorders
3.6K
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
3.6K
01:25Chronic Kidney Disease I: Introduction
17
Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage kidney disease (ESKD). At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate...
17