慢性病的新兴预防策略:最近的证据和知识上的差距
Nishigandha Pradhan1,2, Mirela Dobre3,4
1Division of Nephrology and Hypertension, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
Current atherosclerosis reports
|December 1, 2023
概括
新的SGLT2抑制剂和矿物质皮质类受体对抗剂减缓慢性病 (CKD) 的进展. 早期检测和新的生物标志物也可以提高CKD预防策略,以获得更好的心血管结果.
科学领域:
- 腎病學和心血管醫學.
- 药理学和治疗学 药理学和治疗学
背景情况:
- 慢性病 (CKD) 是一个日益严重的全球健康问题.
- 慢性病显著增加了心血管疾病 (CVD),发病率和死亡率的风险.
研究的目的:
- 审查新出现的证据,并确定CKD预防策略中的知识差距.
- 突出最近在减缓CKD进展和降低心血管风险方面的进展.
主要方法:
- 对最近的临床试验数据的审查,包括EMPA-脏,DAPA-CKD,CREDENCE,FIDELIO-DKD和FIGARO-DKD.
- 分析非药物干预和基于新生物标志物的风险分层.
- 在CKD中探索分子机制和奥米克模型.
主要成果:
- -葡萄糖共载体2抑制剂 (SGLT2i) 减少了CKD进展或心血管死亡28% (EMPA-脏).
- 在聚合分析中,芬瑞能减缓了23%的糖尿病病进展.
- 低蛋白饮食和早期检测策略正在获得引力.
结论:
- 现在SGLT2抑制剂是糖尿病和非糖尿病CKD的基石疗法.
- 菲内伦在减缓糖尿病病进展方面表现有前途.
- 对CKD异质性和分子机制的进一步研究对于个性化疗法至关重要.
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