我们应该扩大糖尿病患者脏活检的指示吗? 内容部分是内容部分
Alberto Ortiz1,2,3
1Department of Nephrology and Hypertension, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain.
Clinical kidney journal
|January 8, 2024
概括
活检在糖尿病 (DM) 和慢性病 (CKD) 患者中经常被过度使用. 优先考虑具有成本效益的尿检可以改善早期检测和资源配置,以获得更好的患者结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
- 生物标志物发现发现
背景情况:
- 糖尿病 (DM) 是慢性病 (CKD) 的主要原因,影响全球8.5亿人.
- 预计到2040年,CKD将成为全球第五大死亡原因.
- 目前的研究旨在确定DM-CKD患者的脏组织表型,以针对性治疗.
研究的目的:
- 评估脏活检在DM和CKD患者的常规护理中的有用性和必要性.
- 评估脏活检结果是否通常会改变超越标准护理的治疗方法.
- 倡导在管理DM-CKD时优化资源配置.
主要方法:
- 关于DM-CKD患者脏活检的当前临床实践的审查.
- 分析活检结果对治疗决策的潜在影响.
- 脏活检和尿蛋白:肌素比率评估之间的成本效益比较.
主要成果:
- 在DM-CKD患者中,脏活检经常不会导致标准治疗方案 (三倍/四倍疗法) 的改变.
- 扩大活检标准可能会导致活检相关并发症和死亡人数显著增加.
- 尿白蛋白:肌素比率测试是早期疾病检测的经济有效的替代方案.
结论:
- 活检在DM-CKD的治疗中可能被过度利用.
- 非侵入性生物标志物和成本有效的查测试对于早期诊断和管理至关重要.
- 资源分配应优先考虑提供更广泛益处和更少风险的策略,例如尿白蛋白:肌素比率测试.
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