孕期功能正常参考间隔的发展:对临床试验数据的二次分析
Zandile Legoabe1, Motshedisi Sebitloane1, Carl Lombard2,3
1Department of Obstetrics and Gynaecology, School of Clinical Medicine, University of KwaZulu Natal, Durban, South Africa.
概括
这项研究为健康的非洲孕妇建立了关键的功能参考范围. 这些发现有助于在怀孕期间安全使用二酸烟酸 (TDF) 预防艾滋病毒.
科学领域:
- 产科和妇科 产科和妇科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
背景情况:
- 由于潜在的毒性,在开始Tenofovir二酸盐烟酸盐 (TDF) 治疗之前,查脏功能障碍至关重要.
- 确定妊娠特异性功能参考值对于准确的非洲妇女临床评估至关重要.
研究的目的:
- 为了确定血清肌素 (sCr) 和肌素清除率 (CrCl) 的参考值,在健康的非洲裔孕妇中.
- 提供准确的功能基准,用于TDF治疗和怀孕期间启动暴露前预防 (PrEP).
主要方法:
- 在南非德班的一项PrEP试验中注册的HIV阴性孕妇 (≥18岁).
- 在整个怀孕和产后期间,每4周监测功能标志物 (sCr,CrCl).
- 使用Cockcroft-Gault (CG) 和脏疾病 (MDRD) 中饮食修改公式计算了CrCl.
主要成果:
- 对于怀孕的第二和第三个三个月,sCr和CrCl的正常参考范围已确定.
- 发现sCr正常的上限 (ULN) 在怀孕期间比分娩后低约20%.
- 观察到的CrCl正常的下限 (LLN) 在怀孕期间大约比分娩后高35%.
结论:
- 在非洲孕妇中提供了sCr和CrCl的三个月特定的正常参考范围.
- 在怀孕和产后期间,突出显示了功能标志物的显著差异.
- 强调使用妊娠调整的参考范围来评估功能的重要性.
相关概念视频
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01:11Renal Failure: Dose Adjustments
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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
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01:23Renal Clearance
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01:08Renal Drug Clearance: Comparison Between Renal Excretion Methods
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