血液透析患者的出血风险 血液透析患者
Anita van Eck van der Sluijs1, Pearl Pai2, Wenjuan Zhu3
1Department of Internal Medicine, Deventer Hospital, Deventer, The Netherlands.
Seminars in nephrology
|January 18, 2024
概括
透析患者面临高心血管风险. 本综述检查了血液透析患者常见的抗血栓性疗法 (如肝素和抗凝固剂) 的出血风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 心血管疾病 (CVD) 对于接受透析的患者来说是一个主要问题.
- 在这种人群中,抗血小板和抗血栓药物经常被处方用于心血管疾病.
- 这些治疗方法的疗效和安全性可能在透析患者与普通人群相比有所不同.
研究的目的:
- 在血液透析患者中审查与特定抗血栓治疗相关的出血风险.
- 评估抗凝剂和抗血小板剂在血液透析中的益处风险概况.
主要方法:
- 对血液透析患者的抗血栓和抗血小板药物研究的文献综述.
- 分析与肝素,维生素K对抗剂和直接口服抗凝剂相关的出血事件和治疗结果.
- 专注于末期病中抗凝剂的独特考虑.
主要成果:
- 透析患者表现出抗血栓药物的药理动力学和药理动力学变化.
- 在这个队列中,肝素,维生素K对抗剂和直接口服抗凝剂增加的出血风险是一个重大问题.
- 对透析患者新型口服抗凝剂的确切益处风险平衡的数据仍在不断发展.
结论:
- 谨慎考虑出血风险至关重要,在给血液透析患者开处方抗血栓治疗时.
- 个性化治疗策略是必要的,以优化抗凝血和最大限度地减少出血.
- 需要进一步的研究,以制定清晰的指导方针,用于透析人群的抗血栓药物使用.
相关概念视频
Dialysis
319
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...
319
Disorders of Hemostasis
918
Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
918
Renal Failure: Dose Adjustments
92
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...
92
Anticoagulant Drugs: Low-Molecular-Weight Heparins
701
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
701
Blood Pressure Imbalances and Circulatory Shock
781
Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
781
Heart Failure Drugs: Diuretics
384
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
384


