对慢性病快速进展的风险因素分析
Anne H S Vestergaard1, Simon K Jensen1, Uffe Heide-Jørgensen1
1Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
概括
识别新的慢性病 (CKD) 阶段G3患者具有快速进展的高风险至关重要. 易于获得的标记物,如白蛋白尿症,性,糖尿病和心血管疾病,可以在日常护理中预测CKD的快速进展.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 慢性病 (CKD) 构成了日益严重的全球健康挑战.
- 有限的社区数据可用于识别患有快速进展高风险的新发性CKD患者.
- 早期识别对于实施预防性干预至关重要.
研究的目的:
- 检查发生性CKD G3阶段的成年人中快速进展,衰竭,住院和死亡的风险.
- 澄清预定义的风险标志物与CKD快速进展之间的关联.
主要方法:
- 全国范围,基于人口的队列研究,使用来自丹麦医院和初级保健的血肌素 (2017-2020).
- 包括发生CKD阶段G3的成年人.
- 估计快速进展的3年风险 (eGFR≥5毫升/分钟/1.73米2/年下降),功能衰竭,住院和死亡.
- 构建热图以可视化基于白蛋白尿症,性别,糖尿病和高血压/心血管疾病的风险.
主要成果:
- 在133,443名发生性CKDG3阶段的个体中,快速进展的3年风险为14.6%.
- 三年风险为功能衰竭的0.3%,住院的53.3%,死亡的18.1%.
- 快速进展的风险从7%的低风险女性到46%-47%的高风险男性和患有白蛋白尿,糖尿病和高血压/心血管疾病的女性.
结论:
- 结核病G3阶段与社区环境中的显著发病率有关,需要优化预防干预措施.
- 可访问的标记物,如白蛋白尿症,性别,糖尿病和心血管疾病可以有效地识别高风险的个体,以快速进展.
- 这些发现支持在CKD管理中使用常规临床数据进行风险分层.
相关概念视频
01:17Factors Affecting Renal Clearance: Renal Impairment
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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...
95
01:11Renal Failure: Dose Adjustments
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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...
94
01:27Dialysis
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Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
320
01:31Factors Affecting Renal Clearance: Drug's Physicochemical Properties and Plasma Levels
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Renal clearance of a drug is influenced by various factors, including its physicochemical properties and plasma levels. These factors play a significant role in determining how efficiently the kidneys eliminate a drug.
One important factor is the drug's molecular size. The kidneys readily excrete smaller molecules below 300 Daltons (Da). On the other hand, molecules weighing between 300 and 500 Da are excreted through both urine and bile. Larger molecules above 500 Da tend to be excreted...
One important factor is the drug's molecular size. The kidneys readily excrete smaller molecules below 300 Daltons (Da). On the other hand, molecules weighing between 300 and 500 Da are excreted through both urine and bile. Larger molecules above 500 Da tend to be excreted...
236
01:10Nephrons
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The kidneys are intricate organs with millions of working units known as nephrons. Each nephron features two major structures: the renal corpuscle, which facilitates blood plasma filtration, and the renal tubule, which handles the glomerular filtrate. Blood supply is directly linked to the nephrons. The renal corpuscle consists of the glomerulus, a capillary network, and the Bowman's capsule, a double-walled epithelial structure that encases the glomerulus. The filtering of blood plasma...
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01:09Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions
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Renal clearance plays a pivotal role in drug elimination from the body and can be influenced by drug distribution and interactions. Understanding these factors is crucial in pharmacology as they impact the effectiveness and duration of drug therapy.
One important factor is the relationship between renal clearance and the apparent volume of distribution. Renal clearance tends to be inversely proportional to the apparent volume of distribution. Drugs with an extensive distribution volume or those...
One important factor is the relationship between renal clearance and the apparent volume of distribution. Renal clearance tends to be inversely proportional to the apparent volume of distribution. Drugs with an extensive distribution volume or those...
137