在接受血液透析的患者中,酸盐结合剂药物的负担和心血管事件
Kiryu Yoshida1, Tomohiro Saito2, Tadashi Kato2
1Division of Nephrology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Japan.
概括
高酸盐结合剂 (PB) 药片负担与血液透析患者心血管事件增加有关. 每天服用9粒或更多药物的患者,与服用更少药物的患者相比,面临的风险明显更高.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 临床药房 临床药房
背景情况:
- 酸盐结合剂 (PBs) 对于治疗血液透析患者的高酸血症至关重要.
- 每天的药丸负担可能会影响患者的坚持和临床结果.
- 心血管疾病是末期病患者死亡的主要原因.
研究的目的:
- 调查每天服用的酸盐结合剂药片数量与心血管事件发生之间的关联.
- 为了确定更高的药丸负担是否与血液透析患者心血管风险增加有关.
主要方法:
- 一项回顾性队列研究,涉及日本395名血液透析患者.
- 根据每日PB摄入量,患者被分为三组:<4,4-8和≥9片.
- 考克斯的比例危险模型 (基线,时间平均值,时间依赖) 用于统计分析.
主要成果:
- 在395名患者中,心血管事件发生在30.6%的患者中.
- 与服用<4粒/天 (HR=1.51) 和4-8粒/天 (HR=2.06) 的患者相比,服用药物负担最高的第三位 (≥9粒/天) 患者的心血管事件风险显著增加.
- 这些发现在不同的建模方法中是一致的.
结论:
- 每天摄入9个或更多的酸盐结合剂药片与心血管事件的风险大幅增加有关.
- 减少PB药丸负担可能是减轻血液透析患者心血管风险的策略.
- 对优化PB疗法的进一步研究是有必要的.
相关概念视频
Heart Failure Drugs: Diuretics
318
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...
318
Drug Distribution: Tissue Binding
2.5K
Upon entering the systemic circulation, drugs can distribute into the interstitial and intracellular fluid of various tissue cells. This distribution is facilitated by the binding of drugs to different cellular components within tissues, which may lead to drug accumulation in specific areas. Drugs bound to tissue components serve as reservoirs that release free drugs back into the system, prolonging the drug's overall action. However, this accumulation can also result in local toxicity.
For...
For...
2.5K
Antihypertensive Drugs: Potassium-Sparing Diuretics
429
Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
429
Antihypertensive Drugs: Thiazide-Class Diuretics
500
Thiazide diuretics are sulfonamide derivatives featuring a benzothiadiazine ring system in their molecular structure. Based on this structure, thiazide diuretics can be categorized into two groups: thiazide-type and thiazide-like diuretics. Thiazide-type diuretics, including hydrochlorothiazide and chlorothiazide, consist of a benzothiadiazine backbone with an attached sulfonamide group. Thiazide-like diuretics, such as chlorthalidone and indapamide, lack the thiazide ring but demonstrate...
500
Antihypertensive Drugs: Action of Diuretics
601
Diuretics are antihypertensive drugs used to treat hypertension resulting from sodium and water retention. Sodium, vital for fluid balance and nerve or muscle function, is regulated by the kidneys through millions of nephrons. Blood enters nephrons via afferent arterioles, which branch into capillaries called glomeruli. These filter blood plasma, allowing water and solutes, like sodium ions, to pass through capillary walls into Bowman's capsule. The filtrate then flows through various...
601
Factors Affecting Protein-Drug Binding: Patient-Related Factors
34
Protein-drug binding, a pivotal aspect of pharmacokinetics, is subject to considerable variability influenced by an array of patient-related factors. The intricate interplay of age, individual differences, and pathological conditions significantly impact the binding dynamics and subsequent pharmacological effects.
Age stands as a key determinant in protein-drug binding. Neonates, characterized by low albumin content, experience heightened concentrations of unbound drugs such as phenytoin and...
Age stands as a key determinant in protein-drug binding. Neonates, characterized by low albumin content, experience heightened concentrations of unbound drugs such as phenytoin and...
34


