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慢性病患者的功能下降和严重不良药物反应
Solène M Laville1, Valérie Gras-Champel2, Aghilès Hamroun3
1Pharmacoepidemiology Unit, Department of Clinical Pharmacology, Amiens-Picardie University Medical Center, Amiens; MP3CV Laboratory, Jules Verne University of Picardie, Amiens.
概括
药物不良反应 (ADR) 在慢性病 (CKD) 患者中很常见. 下功能显著增加严重副作用的风险,其中许多是可以预防的.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床药理学 临床药理学
- 药学流行病学 药学流行病学
背景情况:
- 药物不良反应 (ADR) 是慢性病 (CKD) 患者的一个重大问题.
- 功能下降和严重副作用的风险之间的关系尚未被彻底研究.
- 患有中度至高级CKD的患者经常管理复杂的药物治疗方案.
研究的目的:
- 描述中度至晚期CKD患者的ADR发生率和类型.
- 评估估计的膜过率 (eGFR) 与严重副作用的风险之间的关联.
- 在这个人群中识别潜在的可预防的副作用.
主要方法:
- 采用了前性队列研究设计.
- 分析了来自法国CKD-REIN队列的3033名参与者的数据.
- 专家药理学家确定并判定了严重的副作用;统计模型评估了eGFR和ADR风险之间的关系.
主要成果:
- 在4.7年的中位数随访期间,360名患者发生了488次严重的副作用.
- 脏/尿路疾病和出血是最常见的严重副作用,占病例的70%.
- 较低的eGFR是一个显著的风险因素;每1mL/min/1.73m2的eGFR下降,急性损伤风险增加了2.2%,出血风险增加了8%. 超过27%的副作用是可以预防的.
结论:
- 副作用是CKD患者住院的主要原因之一.
- 降低功能 (较低的EGFR) 是严重副作用的重要危险因素.
- 专注于处方指南和功能监测的干预措施对于预防CKD患者的ADR至关重要.
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