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相关概念视频

Nephrotic Syndrome I : Introduction01:24

Nephrotic Syndrome I : Introduction

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Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...
469
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

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Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
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Nephrotic Syndrome III : Nursing Management01:24

Nephrotic Syndrome III : Nursing Management

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Nursing management for nephrotic syndrome adapts as the disease progresses, with strategies evolving to address advancing symptoms and complications.Early-Stage Management In the early stages, nursing interventions for nephrotic syndrome resemble those used in managing acute glomerulonephritis, focusing on symptom monitoring, fluid balance, and managing mild to moderate edema.Vital Signs: Regularly monitor blood pressure, pulse, respiratory rate, and temperature to promptly identify...
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Imaging Studies VII: Vascular Imaging01:19

Imaging Studies VII: Vascular Imaging

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DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
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Renal Corpuscle01:20

Renal Corpuscle

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The glomerulus and Bowman's capsule are two essential components of the nephron, which is the functional unit of the kidney. These microscopic structures play a critical role in the process of blood filtration to produce urine.
Glomerulus: Structure and Function
The glomerulus is a tiny, intricate network of capillaries located at the beginning of the nephron. It's enveloped by the Bowman's capsule and receives its blood supply from an afferent arteriole, which divides into numerous...
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5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat
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患有晚期功能障碍的患者中原性系统性纤维化 在使用加多基对比剂后.

Adarsh Mallepally1, Jason M Kidd2, John D Grizzard3

  • 1School of Medicine, Virginia Commonwealth University, Richmond, Va.

Radiology
|December 16, 2025
PubMed
概括

在晚期慢性病 (CKD) 或末期病 (ESRD) 患者使用加多基对比剂 (GBCA) 后,发生原体系统纤维化 (NSF) 的风险非常低. 这项现实研究发现,与对照组相比,NSF风险没有显著增加.

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科学领域:

  • 放射学和医学成像学 医学成像学
  • 科和脏疾病.
  • 药物监督 药物监督 药物监督

背景情况:

  • 当代基于加多的对比剂 (GBCA) 在MRI中用于患有晚期慢性病 (CKD) 或末期病 (ESRD) 的患者.
  • 在这个人群中,这些药物对原体系统性纤维化 (NSF) 的感知风险被认为是低的,但大规模实验研究的数据是有限的.
  • 准确的风险评估对于平衡对比增强MRI的益处与功能障碍患者的潜在不良事件至关重要.

研究的目的:

  • 为了估计与当代GBCA相关的NSF的现实风险,在被诊断为晚期CKD或ESRD的患者中.
  • 将接受GBCA的晚期CKD/ESRD患者的NSF发病率与没有功能障碍的匹配对照组进行比较.

主要方法:

  • 在2010年1月至2025年1月期间接受GBCA的4-5期CKD或ESRD成年患者的回顾性分析,来自TrinetX美国网络.
  • 使用倾向分数匹配 (PSM) 来创建具有相似人口特征和并发症的对照组.
  • 主要终点:可能的NSF (ICD-10代码L90.8);次要终点:可能的NSF混. 评估是在GBCA给药一年内进行的. 使用了风险比率 (RR) 和卡普兰-梅尔分析.

主要成果:

  • 共有73,022名接受GBCA的晚期CKD或ESRD的成年人被确定. 在PSM之后,在GBCA组和对照组中,可能出现NSF代码的发生率为0.05% (RR,1.00;P>.99).
  • 在两组之间,NSF混代码的比率是相似的 (0.74%对0.71%;RR,1.05;P = .46).
  • 对NSF的诊断代码率在接受不同类型当代GBCA (ACRII组和宏循环药物) 和没有功能障碍的对照组的患者之间是可比的.

结论:

  • 在这个大规模的现实分析中,在晚期CKD或ESRD患者同时服用GBCA后,可能出现NSF的诊断代码的概率极低.
  • 在这种接受GBCA的患者群体中,NSF的风险并不明显大于在没有功能障碍的匹配对照中观察到的风险.
  • 当代GBCA在现实临床实践中使用时,在患有晚期病的患者中,在NSF风险方面似乎是安全的.