慢性病患者的抗胆固醇负担:模式,危险因素和与认知障碍的联系
Agathe Mouheb1,2, Hélène Levassort3,4, Ziad A Massy3,5,6
1Pharmacoepidemiology Unit, Department of Clinical Pharmacology, Amiens-Picardie University Hospital, Amiens, France.
Journal of the American Geriatrics Society
|November 28, 2024
概括
患有慢性病 (CKD) 的患者服用抗胆固醇特性药物,面临更高的认知障碍 (CI) 风险. 这项研究强调了对CKD患者仔细处方这些药物的重要性,以减轻潜在的认知衰退.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 老年病的医生 老年病的医生
- 药理学 药理学是指药理学的学科.
背景情况:
- 慢性病 (CKD) 与认知障碍 (CI) 的风险增加有关.
- 抗胆固醇药物可以对中枢神经系统产生负面影响.
- 在CKD患者中抗胆固醇负担和CI之间的联系仍未得到充分探索.
研究的目的:
- 记录CKD患者抗胆固醇药物处方的流行情况.
- 为了确定与这些药物的处方相关的因素.
- 评估抗胆固醇负担与CKD认知表现之间的关系.
主要方法:
- 对患有慢性脏病的脏病门诊患者进行前性队列研究 (CKD-REIN).
- 在5年内对药物处方的预期记录.
- 使用迷你精神状态检查 (MMSE) 评估认知功能;CI定义为MMSE得分<24/30.
- 使用抗胆固醇认知负担 (ACB) 尺度计算抗胆固醇负担.
- 使用后勤回归分析,分析与ACB得分相关的因素以及ACB和CI之间的关联.
主要成果:
- 分析了3000多名CKD患者,52%的人被处方至少一种抗胆固醇药物.
- 高抗胆固醇负担与神经/精神疾病病史和更高的每日药物使用量有关.
- 经过调整后,抗胆固醇负担较高的患者表现出认知障碍的可能性显著增加 (OR=1.76 [1.12;2.75]).
结论:
- 在CKD患者中,高抗胆固醇负担和认知障碍之间存在显著的关联.
- 在CKD中处方抗胆固醇药物的做法需要仔细考虑.
- 减少抗胆固醇药物暴露可能是预防CKD认知衰退的策略.
相关概念视频
Factors Affecting Renal Clearance: Renal Impairment
54
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...
54
Cognitive Enhancers: Cholinesterase Inhibitors and NMDA Receptor Antagonists
98
Cognitive enhancers, also known as "smart drugs," are substances used to enhance memory, mental alertness, and concentration. These can be natural or synthetic and improve cognition in conditions like Alzheimer's disease (AD) and other neurodegenerative diseases. Some common examples include caffeine, amphetamines, methylphenidate, modafinil, arecoline, donepezil, vortioxetine, and piracetam. These enhancers work on the principle of synaptic plasticity and altered circuit function.
98
Heart Failure Drugs: Diuretics
343
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
343
Indirect-Acting Cholinergic Agonists: Pharmacological Actions
618
Indirect-acting cholinergic agonists, also known as anticholinesterases, exert their pharmacological effects by enhancing cholinergic transmission in various body parts, including the neuromuscular junction, autonomic cholinergic synapses, and the brain.
At the neuromuscular junction, these agents work by inhibiting the breakdown of acetylcholine, allowing it to remain bound to the receptor and bind to nearby receptors. This process leads to repetitive firing of the endplate, causing muscle...
At the neuromuscular junction, these agents work by inhibiting the breakdown of acetylcholine, allowing it to remain bound to the receptor and bind to nearby receptors. This process leads to repetitive firing of the endplate, causing muscle...
618
Renal Failure: Dose Adjustments
64
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...
64
Alzheimer's Disease: Treatment
165
Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
165


