脏酸盐的浪费预测了多囊性脏病的不良结果
Laixi Xue1, Frank Geurts1, Esther Meijer2
1Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus Medical Center, Rotterdam, The Netherlands.
概括
酸盐浪费在自身主导多囊性病 (ADPKD) 中很常见,表明功能下降的速度更快. 这一发现表明早期的管状功能障碍,可能有助于预测ADPKD的进展.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
- 遗传学 遗传学 是一个
背景情况:
- 自体主导性多囊性病 (ADPKD) 患者经常表现出纤维细胞生长因子23 (FGF-23) 水平升高.
- 一小部分ADPKD患者患有酸损耗,影响这种情况的因素及其预后意义尚未完全理解.
研究的目的:
- 调查与ADPKD中脏酸盐浪费相关的因素.
- 为了确定酸盐浪费是否预测ADPKD患者的疾病进展.
主要方法:
- 一项多中心前性观察性研究 (DIPAK) 包括604名ADPKD患者.
- 测量了副甲状腺激素 (PTH),血FGF-23,并计算了酸盐的管状最大再吸收率到膜过率 (TmP/GFR).
- 定义酸损耗为TmP/GFR<0.8 mmol/L,并分析了与估计的GFR (eGFR) 降低和复合结局的关联.
主要成果:
- 59%的ADPKD患者表现出酸盐的浪费.
- 酸盐浪费与男性性别,较低的eGFR,较高的fgf-23和copeptin以及较低的pth相关.
- 在TmP/GFR下降与加速的eGFR下降和增加脏不良结果的风险相关,独立于PTH,FGF-23和eGFR.
结论:
- 脏酸盐浪费在ADPKD中很普遍,并且与更快的疾病进展有关.
- 酸盐浪费可能源于早期近接管管功能障碍和不充分的PTH抑制.
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