根据功能和年龄根据利尿剂使用者之间的电解质障碍的性别差异
Narumi Maida1,2, Shingo Kondo3,4, Naoko Hayashi1,2
1Division of Social Pharmacy, Center for Social Pharmacy and Pharmaceutical Care Sciences, Faculty of Pharmacy, Keio University, Tokyo, Japan.
Drug safety
|June 25, 2025
概括
使用利尿剂的老年妇女面临较高的低血风险,特别是功能下降. 密切监测这种电解质干扰在这个人口群体中至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 药理学 药理学是指药理学的学科.
- 老年病的医生 老年病的医生
背景情况:
- 在日本,利尿剂对于治疗高血压和心力衰竭至关重要.
- 电解质障碍,是尿液剂的严重不良反应,在女性中更为普遍.
- 随着年龄的增长,功能下降,可能会增加对这些障碍的敏感性.
研究的目的:
- 为了确定患有尿液诱导电解质障碍高风险的患者.
- 调查性别,年龄和功能对敏感性的影响.
- 为目标监测和风险减轻策略提供信息.
主要方法:
- 分析了来自日本67,135名利尿剂使用者的索赔数据 (2020年4月至2021年3月).
- 利用奇平方测试来比较两性之间的电解质干扰频率.
- 计算的几率比率 (ORs) 与95%的置信区间 (CI) 对于女性,考虑到年龄和估计的膜过率 (eGFR).
主要成果:
- 超血症在男性中更常见 (326对271;p=0.003),而低血症在女性中更常见 (413对285;p<0.001).
- 老年妇女 (≥75岁) 具有较低的EGFR (60-30毫升/分钟/1.73米2和<30毫升/分钟/1.73米2),与男性相比,患低血的几率明显更高.
- 具体来说,75岁以上女性的低血的OR为1.47 (95% CI 1.13-1.91) 对于eGFR 60-30和2.05 (95% CI 1.08-4.10) 对于eGFR <30.
结论:
- 患有功能减弱 (低EGFR) 的老年妇女在服用利尿剂时,患低血的风险增加.
- 这些发现强调了在这个特定的患者群体中对低血的警监测的重要性.
- 基于性别,年龄和功能的风险分层对于安全的利尿剂治疗至关重要.
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