一个复杂问题的基本解决方案:代谢性酸性疾病的治疗是否会减缓CKD的进展?
Kevin Bodker1, Natalie Freidin1, Nayan Arora2
1Medical University of South Carolina.
Current opinion in nephrology and hypertension
|February 29, 2024
概括
慢性病 (CKD) 患者的代谢酸性症的常规治疗没有得到当前证据的支持. 最近的研究挑战了早期的发现,表明性疗法可能不会减缓CKD的进展.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内部医学 内部医学
- 临床实践指南 临床实践指南
背景情况:
- 代谢性酸症在慢性病 (CKD) 中很常见,随着功能下降,患病率会增加.
- 治疗以使血清二碳酸盐正常化并减缓CKD进展是一种长期的做法,基于动物模型和有争议的临床试验.
研究的目的:
- 批判性地评估支持常规性疗法用于CKD患者的代谢性酸化的文献.
- 确定当前的证据是否支持治疗慢性病中代谢性酸性病的既定临床实践.
- 根据即将发生的KDIGO指南变更,为临床实践提供信息.
主要方法:
- 系统审查和对现有文献的批判性评价.
- 分析早期的开放标签研究与最近的盲目的研究.
- 评估研究特定治疗方法的试验,如veverimer.
主要成果:
- 以前的研究表明,二碳酸治疗减缓了CKD的进展,但最近的盲目的研究没有显示这种益处.
- 一个使用盐酸结合剂veverimer的试验也未能证明对结局或GFR降低有显著益处.
- 总体而言,证据不支持在CKD患者中常规治疗代谢性酸性化症.
结论:
- 目前的文献不支持在患有CKD的患者中常规治疗代谢酸性症.
- 作者同意即将发布的KDIGO指南,以减轻这种常见的做法.
- 可能需要进一步的研究来澄清疗法在特定CKD人群中的作用.
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