脏移植后患者的利尿剂使用:回顾性图表审查
Zohreh Gholizadeh Ghozloujeh1, Soo Min Jang2, Amir Abdipour1
1Department of Medicine, Division of Nephrology, Loma Linda University School of Medicine, Loma Linda, California.
Transplantation proceedings
|January 10, 2024
概括
在移植患者中使用罗塞米德并没有防止移植功能的延迟,并且与更糟糕的结果有关. 这种利尿剂可能会增加毒性风险,并延长住院时间,这表明在这个人群中应该避免使用它.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植手术 移植手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 延迟移植功能 (DGF) 增加了排斥风险,并减少了器官移植后的存活率.
- 循环利尿剂,如furosemide,通常用于管理移植患者的寡尿症.
- 罗塞米德对脏移植接受者的DGF发病率的影响需要进一步调查.
研究的目的:
- 评估罗塞米德对移植受体中延迟移植功能 (DGF) 的发生率的影响.
- 在移植后的30天和90天,比较肌素水平和估计的淋巴球过率 (eGFR) 在接受罗塞米德和未接受罗塞米德的患者之间.
主要方法:
- 对成年移植接受者的医疗记录的回顾性审查.
- 对人口特征和移植结果的分析.
- 主要终点:DGF发病率;次要终点:移植后30日和90天的肌素水平和eGFR.
主要成果:
- 这项研究包括330名脏移植患者;169人接受了罗塞米德,161人没有.
- 罗塞米德组 (44%) 的DGF发生率明显高于非罗塞米德组 (4%).
- 接受罗塞米德治疗的患者在移植后30天和90天的EGFR水平较低,与没有接受罗塞米德治疗的患者相比.
结论:
- 罗塞米德的使用在移植后治疗寡性急性损伤 (AKI) 时没有任何益处.
- 发胺的使用,特别是高剂量,可能会增加毒性风险,延迟透析的开始,并延长住院时间.
- 目前的研究结果表明,为了减轻潜在的不良影响,在移植接受者中应避免使用furosemide.
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