住院治疗对基于囊素C和肌素的估计GFR的差异影响
Ian E McCoy1, Alan S Go2, Jesse Y Hsu3
1Division of Nephrology, University of California San Francisco, San Francisco, California.
Journal of the American Society of Nephrology : JASN
|March 11, 2025
概括
住院治疗显著降低功能估计通过囊素C (eGFRCys),但不是血清肌素 (eGFRCr). 这种对功能的影响在出院后仍然存在,影响了eGFRdiff计算.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床化学 临床化学
- 功能的生物标志物
背景情况:
- 血清肌素是长期以来对功能的一个生物标志物,而囊素C是一种较新的替代品.
- 从肌素 (eGFRCr) 和囊素C (eGFRCys) 估计的GFR之间的差异很常见,特别是在住院患者中.
- 所有原因的住院住院对这些功能估计的影响以及它们在出院后的持久性尚未得到充分了解.
研究的目的:
- 调查住院时间与功能标志物变化之间的关联.
- 为了比较住院对eGFRCr和eGFRCys的影响.
- 为了确定功能估计的变化是否在医院出院后仍然存在.
主要方法:
- 分析了5599名慢性功能缺陷队列研究的成年参与者的数据.
- 根据每年研究访问之间的住院总日数对参与者进行分类.
- 随着时间的推移,对eGFRCr,eGFRCys及其差异 (eGFRdiff) 的变化估计.
主要成果:
- 住院日数的增加与eGFRCys.的显著下降有关.
- 随着住院日数的增加,eGFRCr显示出最小的变化.
- 随着住院时间的延长,eGFRCys和eGFRCr (eGFRdiff) 的差异变得越来越负面.
结论:
- 长期或重复住院导致基于囊素C的GFR估计比基于肌素的估计减少得更多.
- 这些对功能标志物的影响,即使在医院出院数月后也可以观察到.
- 住院时间是影响不同GFR估计方法可靠性的关键因素.
相关概念视频
01:17Factors Affecting Renal Clearance: Renal Impairment
47
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...
47
01:23Renal Clearance
656
The glomerular filtration rate (GFR) is a critical marker of kidney function, reflecting the efficiency of filtration by the glomeruli. Renal clearance of specific substances, such as inulin or creatinine, is commonly used to measure GFR.
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...
656
01:02Renal Drug Excretion: Glomerular Filtration
117
The kidney serves as the primary organ responsible for eliminating drugs and their metabolites from the body. This process, known as renal elimination, starts with glomerular filtration and results in urine formation. Each kidney houses millions of functional units called nephrons, where urine production occurs. A nephron has two main components: a renal corpuscle and a renal tubule.
Drugs gain access to the kidney via the renal artery, which progressively branches off into afferent arterioles....
Drugs gain access to the kidney via the renal artery, which progressively branches off into afferent arterioles....
117
01:07Determination of Renal Drug Clearance: Graphical and Midpoint Methods
65
Renal clearance, a crucial parameter in pharmacokinetics, can be determined using two different methods: the graphical method and the midpoint method. These methods provide insights into the rate of drug excretion by the kidneys and aid in assessing renal function.
The graphical method involves plotting the rate of drug excretion in urine against the plasma drug concentration. By analyzing the graph, the clearance can be calculated and obtained. Drugs rapidly excreted by the kidneys exhibit a...
The graphical method involves plotting the rate of drug excretion in urine against the plasma drug concentration. By analyzing the graph, the clearance can be calculated and obtained. Drugs rapidly excreted by the kidneys exhibit a...
65
01:28Glomerular Filtration Rate and its Regulation
2.1K
The Glomerular Filtration Rate (GFR) is a measure of kidney function, reflecting the volume of filtrate formed per minute in the kidneys. On average, GFR is approximately 125 mL/min in males and 105 mL/min in females. Maintaining a relatively constant GFR is essential for the kidneys to effectively regulate body fluid homeostasis and maintain extracellular stability.
GFR regulation involves two primary intrinsic controls: the myogenic and tubuloglomerular feedback mechanisms.
The myogenic...
GFR regulation involves two primary intrinsic controls: the myogenic and tubuloglomerular feedback mechanisms.
The myogenic...
2.1K
01:08Renal Drug Clearance: Comparison Between Renal Excretion Methods
55
Renal clearance is a critical parameter encompassing kidney filtration, secretion, and reabsorption processes. It is calculated using a specific equation to determine the rate at which the kidneys clear a drug.
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
55