尼亚辛胺补充剂对荷兰透析患者酸盐度的影响:一个随机交叉试验
Lara Schepers1, Inez Jans2, Gerda K Pot3
1Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.
概括
氨胺 (NAM) 有效降低血清酸盐在血液透析脏功能衰竭患者. 这种维生素B3衍生物作为补充疗法耐受性很好,在治疗高酸盐血症方面表现有前途.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 生物化学 生化学
- 临床营养学 临床营养学
背景情况:
- 高酸盐血症是衰竭患者的常见并发症,通常由标准酸盐结合剂管理不充分.
- 尼阿辛胺 (NAM) 是一种维生素B3的形式,由于其疗效和与尼阿辛相比改善的副作用概况,它具有潜在的替代或辅助疗法.
- 在末期病中,需要有效和安全的治疗方法来控制血清酸盐水平至关重要.
研究的目的:
- 评价尼阿辛胺 (NAM) 作为降低脏衰竭患者血清酸盐度的补充治疗的疗效.
- 评估NAM的耐受性和安全性,特别是监测血小板计数和因副作用而导致的退学率.
- 在接受血液透析的患者中,比较NAM与安慰剂的影响.
主要方法:
- 一个双盲,安慰剂控制,随机交叉试验 (DiaNia) 进行了12周.
- 参与者除了他们现有的酸盐结合剂外,还接受了NAM (250-500 mg/天) 或安慰剂.
- 主要结局是血清酸盐水平;次要结局包括血小板计数和不良事件. 进行了每项方案和治疗意图分析.
主要成果:
- 尼阿辛胺治疗导致血清酸盐水平显著降低0.59 mg/dL (p=0.03) 在每项方案的人群中.
- 治疗间的0.77 mg/dL的差异有利于NAM比安慰剂 (95% CI 0.010,1.43;P=0.03).
- 没有观察到血小板计数的显著差异,只有8.6%的参与者在NAM治疗期间因副作用而退出.
结论:
- 尼亚辛胺 (NAM) 是一种有效且耐受良好的补充疗法,用于降低血液透析患者的血清酸盐.
- NAM似乎不会增加血小板缺血的风险,这使得它成为管理高酸盐血症的潜在有价值的选择.
- 建议在更大的患者队伍中进行进一步的研究,以证实这些发现,并确定NAM在功能衰竭管理中的作用.
更多相关视频
相关概念视频
Renal Failure: Dose Adjustments
88
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...
88
Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors
156
Phosphodiesterase 5 (PDE5) inhibitors are potent enzymes that function to hydrolyze cyclic nucleotides to their corresponding 5' monophosphates. Their unique biochemical properties have been applied in treating Pulmonary Arterial Hypertension (PAH).
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
156
Antihypertensive Drugs: Vasodilators
516
Vasodilators, primarily affecting the smooth muscles within arterial and venous walls, are commonly used for hypertension treatment. Medications such as minoxidil and hydralazine primarily target arteries and arterioles, while sodium nitroprusside acts on arterioles and venules. Minoxidil, functioning as a prodrug, is metabolized by hepatic sulfotransferase into its active form, minoxidil sulfate, after oral administration. This metabolite binds to the sulfonylurea receptor (SUR) component of...
516
Renal Drug Excretion: Tubular Secretion
180
Active tubular secretion is a robust, energy-demanding process that utilizes carrier systems to transport drugs into renal tubules. The active renal secretion systems include the organic anion transporter (OAT) for weak acids and the organic cation transporter (OCT) for weak bases. Structurally similar drugs can compete for the same transporter, potentially leading to drug accumulation and toxicity. However, this principle can be exploited therapeutically. One example is probenecid (Probalan),...
180
Antihypertensive Drugs: Action of Diuretics
680
Diuretics are antihypertensive drugs used to treat hypertension resulting from sodium and water retention. Sodium, vital for fluid balance and nerve or muscle function, is regulated by the kidneys through millions of nephrons. Blood enters nephrons via afferent arterioles, which branch into capillaries called glomeruli. These filter blood plasma, allowing water and solutes, like sodium ions, to pass through capillary walls into Bowman's capsule. The filtrate then flows through various...
680
Dialysis
309
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...
309


