走向药物诱导脏疾病的当代分类
Iman Karimzadeh1, Erin F Barreto2, John A Kellum3
1Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
Critical care (London, England)
|November 10, 2023
概括
药物诱导性病 (DIKD) 是急性损伤 (AKI) 的主要原因之一. 一个新的框架将DIKD根据功能和损伤分为四个类别,为临床医生和研究人员提高清晰度.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 药物诱导性病 (DIKD) 占急性损伤 (AKI) 病例的很大一部分,特别是在危急病患者中.
- 现有的DIKD诊断标准缺乏标准化,阻碍了一致的临床和研究应用.
- 以前的努力包括2015年专家共识对DIKD.的表型定义.
研究的目的:
- 介绍和描述一种用于分类药物诱导脏疾病 (DIKD) 的新型框架.
- 根据功能变化和组织损伤生物标志物对药物进行分类.
- 讨论在这个新的DIKD分类系统中的影响,临床采用和潜在的患者途径转移.
主要方法:
- 提出了一个新的DIKD分类框架,包括功能变化和组织损伤生物标志物.
- 药物被分为四个不同的组:"无损失的功能障碍"",无损失的损伤"",既有功能障碍和损伤"和"既没有功能障碍也没有损伤".
- 对各种药物和药物类别的毒性机制进行了分析,与拟议的类别相关.
主要成果:
- 拟议的框架根据功能障碍和损伤将药物分为四类.
- 毒性机制和相关药物/药物类别的例子为每个类别提供.
- 该框架允许在特定的临床条件下考虑患者在不同类别之间的疾病进展.
结论:
- 新的DIKD分类框架为临床医生和研究人员提供了更好的清晰度和一致性.
- 该系统将DIKD分类与现有的急性损伤 (AKI) 分类框架保持一致.
- 讨论了在临床实践中采用这种新的DIKD分类的机会和障碍.
相关概念视频
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
18
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...
18
01:22Acute Kidney Injury I: Introduction
12
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
12
01:29Acute Kidney Injury II: Pathophysiology
9
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
9
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
01:25Chronic 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
01:20Acute Kidney Injury V: Interprofessional Care
11
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...
11