在单侧切除术后使用宁-血管素系统阻断剂的脏结果
Sehun Lee1,2, Sungbin Yoon1, Sungmi Kim1
1Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Kidney international reports
|January 15, 2025
概括
在腎切除術後立即使用腎素-血管素系統 (RAS) 阻礙劑不會損壞腎的適應性或增加高血症. 拉斯抑制剂与改善的存活率和切术后末期病风险的降低有关.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 心血管医学 心血管医学
- 药理学 药理学 是一个学科.
背景情况:
- 素-血管素系统 (RAS) 阻断剂提供心血管益处,但由于对脏适应的担忧,它们在脏切除术后的使用受到争议.
- 有限证据表明,RAS抑制剂在单边切除术后对功能产生直接影响.
研究的目的:
- 为了评估立即使用氨酸-血管酶系统 (RAS) 阻断剂对单边切除术后适应的影响.
- 评估术后RAS阻断剂启动的安全性和有效性.
主要方法:
- 在580名接受单侧腎切除手术的高血压患者 (2010-2020) 中进行了单中心回顾性队列研究.
- 根据瘤切除术后的氨酸-血管新生素系统 (RAS) 阻断剂使用情况,患者被分组.
- 主要结局:适应 (1个月后的EGFR比率);二次结局:高胆血症,死亡率,末期病.
主要成果:
- 在RAS阻断剂和对照组之间1个月后适应没有显著差异 (67.1%与66.8%).
- 在外科手术后的第一年内,高卡利米亚的发生率没有增加.
- 使用RAS阻断剂与明显更好的无透析生存率相关 (aHR为0.531,P=0.010).
结论:
- 在单边切除术后,立即使用氨酸-血管素系统 (RAS) 阻断剂不会影响适应或增加高血症的风险.
- 拉斯阻断剂可以改善长期预后,降低脏切除术后的死亡率和末期脏病发病率.
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