缓解移植患者慢性病进展的治疗目标:2024年更新
Moisés Carminatti1, Helio Tedesco-Silva2, Helady Sanders-Pinheiro3
1Nephrology Division, Federal University of Juiz de Fora, Núcleo Interdisciplinar de Estudos e Pesquisas em Nefrologia (NIEPEN), Rua Benjamin Constant, 1044/1001, Centro, Juiz de Fora, Minas Gerais, 36015-400, Brazil.
International urology and nephrology
|May 20, 2025
概括
接受移植 (KTR) 的人面临着非异构风险,如高血压和贫血,这些风险会使病 (CKD) 恶化. 本综述概述了管理这些因素的最新策略,以改善长期移植和患者生存.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植医学 移植医学
- 内部医学 内部医学
背景情况:
- 移植接受者 (KTR) 容易患有非异质性疾病,包括高血压,蛋白尿,贫血,骨矿物质障碍,代谢性酸性疾病和高尿血症.
- 这些非异构因子对KTR.慢性病 (CKD) 的进展有显著的贡献.
- 解决这些风险因素对于改善移植的长期结果至关重要.
研究的目的:
- 审查最新的治疗目标和策略,以管理KTR的非异构风险因素.
- 为解决高血压,蛋白尿,贫血,骨矿物质疾病和其他KTR中的代谢问题提供最新的指导.
- 强调多学科和个性化治疗方法的重要性.
主要方法:
- 对KTR中非异构性CKD风险因素的当前建议和治疗目标的文献综述.
- 专注于从2024年起适用的证据和准则.
- 综合发现,以告知临床实践.
主要成果:
- 在KTR中,血压目标应低于130/80 mmHg.
- 蛋白尿的管理理想目标在500毫克/天以下,使用ACE抑制剂或ARBs.
- 讨论了对血红蛋白水平和骨矿物质疾病早期治疗的修订建议.
- 强调非药物干预和多学科方法,以改善遵守和结果.
结论:
- 总结了KTR中CKD的最新治疗目标.
- 强调这些目标在日常临床实践中的可行性.
- 旨在通过优化管理非异构风险因素来改善长期患者和移植功能存活率.
相关概念视频
01:11Renal Failure: Dose Adjustments
51
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...
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01:17Factors Affecting Renal Clearance: Renal Impairment
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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...
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01:27Dialysis
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Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
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244
01:24Tissue Transplantation
320
Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
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01:22Heart Failure Drugs: Diuretics
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01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
356