欧洲偏远管酸性瘤注册:一个五年分析分析
Marta Giaccari1,2, Faidra Veligratli3, Wesley Hayes3,4
1Universitá Cattolica del Sacro Cuore, Rome, Italy.
概括
维持足够的血液二碳酸盐水平对于偏远管酸性症 (dRTA) 患者的生长至关重要. 达到22-24mmol/L可以改善身高结果,并降低慢性病 (CKD) 风险,特别是在那些有SLC4A1变异的人群中.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 儿科脏病学 儿科脏病学
- 罕见的脏疾病 罕见的脏疾病
背景情况:
- 远端管酸性症 (dRTA) 与代谢酸性症,生长衰竭,骨瘤,质病和慢性病 (CKD) 相结合.
- 之前的研究表明,通过代谢控制改善了结果,但缺乏前性数据.
- 欧洲DRTA注册表于2019年建立,以收集前性数据.
研究的目的:
- 介绍欧洲DRTA注册表的第一个数据分析.
- 确定患有dRTA的患者中CKD和生长障碍的预测因素.
- 评估代谢控制对患者结果的影响.
主要方法:
- 在欧洲罕见病网络中,从2019年2月到2024年5月的前性数据收集.
- 包括标准生长和肌素数据,以及血/尿液生物化学,遗传学,治疗和临床表现.
- 后勤回归分析以确定CKD和生长障碍的预测因素.
主要成果:
- 在214名患者中,69%的患者发现了遗传原因;22%是成年人.
- 低碳酸盐 (<22 mmol/L) 和高尿症分别影响了42%和25%的患者.
- 身高SDS与血清二碳酸盐 (p=0.008) 和早期诊断 (p=0.005) 有正相关性,最佳增长在22-24 mmol/L.
- 30岁以上的患者具有较低的eGFR (p<0.001),36%的人患有CKD≥2期.
- SLC4A1变异与患CKD的风险更高有关 (p=0.013).
结论:
- 代谢控制,特别是将血液二碳酸盐增加到24 mmol/L,对于改善dRTA的增长至关重要.
- 与一般人群相比,患有dRTA的患者从童年就面临更高的CKD风险.
- 潜在的SLC4A1变异增加了dRTA患者中CKD的风险.
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