自体主性多囊性脏病患者所需的水摄入量
Gopala K Rangan1,2,3, Annette T Y Wong1,2, Alexandra Munt1,2
1Michael Stern Laboratory for Polycystic Kidney Disease, Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia.
NEJM evidence
|February 6, 2024
概括
自体主性多囊性病 (ADPKD) 的增加水摄入量并没有减缓囊的生长. 这项为期3年的试验发现,处方饮水组和自由饮水组之间的脏总体积变化没有显著差异.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 遗传学 遗传学 是一个
- 临床试验 临床试验
背景情况:
- 氨酸压缩素有助于 autosomal 主导多囊性病 (ADPKD) 的囊进展.
- 增加水摄入量可以通过降低血管压素水平和尿液度来减轻ADPKD的进展.
研究的目的:
- 为了研究规定的高水摄入量减缓ADPKD患者囊生长的疗效.
- 为了比较处方和任意饮用水对脏总体体积和尿液度的影响.
主要方法:
- 一项为期3年的随机对照试验,涉及184名患有ADPKD的成年人 (梅奥成像子类1B-1E,eGFR≥30毫升/分钟/1.73米2).
- 参与者被分配到规定的水摄入量,以达到尿液度≤270mOsmol/kg或任意饮用水.
- 主要终点:整体体积的年化变化率.
主要成果:
- 在规定的 (6.8%/年) 和随意 (7.8%/年) 水摄入组之间,总体体积的年增长率没有显著差异.
- 在52.3%的患者中,处方饮用水达到目标尿液度,但没有降低血清可佩水平.
- 在为期3年的研究期间,两组的不良事件频率在两组之间是相似的.
结论:
- 在ADPKD患者处方高水摄入量并没有显著减缓脏总体积的增长,而不是在3年内随意摄入.
- 虽然在一半的参与者中实现了目标尿性,但干预措施并没有降低血清可佩.
- 规定的饮用水的策略是安全的,但在改变ADPKD进展方面并不有效,这是通过脏总体积增长来衡量的.
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