抑郁症可以透析吗?
Sourabh Sharma1, Sanjay Sanjay2
1Department of Nephrology, VMMC & Safdarjung Hospital, New Delhi, India.
JPMA. The Journal of the Pakistan Medical Association
|February 14, 2025
概括
抑郁症在慢性病 (CKD) 中很常见. 透析可以通过消除毒素,改善健康和减少压力来缓解抑郁症状,这表明抑郁症可能是"可透析的".
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 精神病学是一个精神病学.
- 内部医学 内部医学
背景情况:
- 抑郁症经常与慢性病 (CKD),特别是末期病 (ESKD) 一起发生.
- 这种并发症源于生物因素,如尿素毒素和炎症,以及心理社会压力因素.
- 渐进性病的心理负担显著影响患者的幸福感.
研究的目的:
- 审查慢性病患者抑郁症的病理生理学.
- 探索启动透析对抑郁症状的影响.
- 评估抑郁症是否可以被归类为"可透析"的疾病.
主要方法:
- 关于链接CKD和抑郁症的病理生理机制的文献综述.
- 对检查透析启动对情绪障碍影响的研究进行分析.
- 对现有证据的评估,以确定ESKD中抑郁症的透析性质.
主要成果:
- 尿素毒素 (中间分子) 的积累和慢性炎症有助于CKD的抑郁.
- 透析可以通过毒素清除,改善身体健康和减轻压力来改善抑郁症状.
- 有证据表明,透析治疗可能会影响抑郁症.
结论:
- 在晚期CKD和ESKD中,抑郁症是显著的并发症.
- 透析为这些患者管理抑郁症提供了潜在的治疗途径.
- 进一步的研究是有必要的,以充分理解和确认抑郁症作为一个"可透析"实体.
相关概念视频
Dialysis
575
Dialysis is a diffusion-based purification process that separates analyte molecules from a complex matrix. This is accomplished by allowing molecules in the solution to pass through a semipermeable membrane into a liquid on the other side. The membrane is usually made of cellulose acetate or cellulose nitrate, and the second liquid must be miscible with the solution. Ions (e.g., chloride or sodium) or organic molecules (e.g., glucose) can pass through the membrane pores, which generally have...
575
Renal Failure: Dose Adjustments
60
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...
60
Factors Affecting Renal Clearance: Renal Impairment
48
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...
48
Antidepressant Drugs: MAOIs and Other Agents
181
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
181
Drug Elimination by Renal Route: Tubular Reabsorption
3.1K
During the process of renal excretion, as the glomerular filtrate progresses to the distal convoluted tubule (DCT), drugs that are highly permeable, lipophilic, and nonionized undergo passive reabsorption from the tubular fluid into the surrounding peritubular capillaries. This reabsorption process restricts their elimination through the kidneys. However, the majority of drugs are either weak acids or weak bases, and their ionization level is dependent on pH. By altering the pH of urine, the...
3.1K
Drug Elimination by Renal Route: Tubular Secretion
2.1K
Once the process of glomerular filtration is completed, blood carrying unfiltered drug molecules traverses through efferent arterioles and makes its way into the peritubular capillaries in the proximal tubule. A variety of carriers play a pivotal role in actively secreting drugs from these peritubular capillaries into the tubular fluid. The organic anion transporter transfers acidic drugs, against an electrochemical gradient, from the peritubular capillaries into the renal tubule cells and...
2.1K


