CCL14测试指导AKI患者的临床实践:来自国际专家小组的结果
John A Kellum1, Sean M Bagshaw2, Sevag Demirjian3
1The Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Journal of critical care
|April 28, 2024
概括
尿中C-C动机化学因配体14 (CCL14) 测试显著改变了持续急性损伤 (AKI) 的临床建议. 这种生物标志物指导了长期3期AKI风险的患者的护理决策.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 生物标志物研究 生物标志物研究
- 临床决策 - 临床决策
背景情况:
- 持续的第三阶段急性损伤 (AKI) 带来了重大的临床挑战.
- 尿中C-C动机化学因子连接体14 (CCL14) 是持续的第3阶段AKI的验证预测剂.
- 目前对AKI的临床行动的应用以及CCL14对这些决定的影响仍然不清楚.
研究的目的:
- 评估尿液CCL14检测结果如何影响3期持续性AKI风险患者的临床建议.
- 评估CCL14对应用已建立的临床行动对AKI管理的影响.
主要方法:
- 一个国际专家小组使用了经过修改的Delphi过程.
- 用利克尔特尺度对患有持续第三阶段AKI风险的患者进行了评价,对11种临床作用进行了评价.
- 在CCL14测试之前和之后评估了建议,并对CCL14结果与推强度/方向之间的关联进行了统计分析.
主要成果:
- CCL14测试结果显著影响了临床建议的强度和方向 (P < 0.001).
- 82%的临床行动建议在将低风险类别与最高风险类别进行比较时,受到CCL14结果的显著影响 (P < 0.001).
结论:
- 专家小组对管理2-3阶段AKI的建议被CCL14测试结果大幅修改.
- 这项研究为开发临床实践方案和未来关于CCL14引导的AKI管理的研究提供了基础.
相关概念视频
01:17Factors Affecting Renal Clearance: Renal Impairment
91
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
91
01:11Renal 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
01:23Renal Clearance
917
The glomerular filtration rate (GFR) is a critical marker of kidney function, reflecting the efficiency of filtration by the glomeruli. Renal clearance of specific substances, such as inulin or creatinine, is commonly used to measure GFR.
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...
917
01:08Renal Drug Clearance: Comparison Between Renal Excretion Methods
128
Renal clearance is a critical parameter encompassing kidney filtration, secretion, and reabsorption processes. It is calculated using a specific equation to determine the rate at which the kidneys clear a drug.
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
128
01:07Determination of Renal Drug Clearance: Graphical and Midpoint Methods
111
Renal clearance, a crucial parameter in pharmacokinetics, can be determined using two different methods: the graphical method and the midpoint method. These methods provide insights into the rate of drug excretion by the kidneys and aid in assessing renal function.
The graphical method involves plotting the rate of drug excretion in urine against the plasma drug concentration. By analyzing the graph, the clearance can be calculated and obtained. Drugs rapidly excreted by the kidneys exhibit a...
The graphical method involves plotting the rate of drug excretion in urine against the plasma drug concentration. By analyzing the graph, the clearance can be calculated and obtained. Drugs rapidly excreted by the kidneys exhibit a...
111
01:27Dialysis
302
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...
302