在COVID-19和非COVID-19患者中,切术后的结果使用ACEi,ARB和SGLT2i:一个N3C数据库研究研究
Jordan Loon1, Meng-Hao Li2, Swati Mehta3
1Department of Medicine, Albany Medical College, Albany, NY, USA.
International urology and nephrology
|March 8, 2026
概括
感染COVID-19增加了末期病 (ESKD),焦点细分结核硬化 (FSGS) 和腎切除术后痛风的风险. 虽然ACE抑制剂/ARBs没有显示任何益处,但SGLT2抑制剂改善了手术后估计的淋巴细胞过率 (eGFR) 趋势.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 脏生理学 脏生理学
- 传染病流行病学 传染病流行病学
背景情况:
- 单侧切除术可以导致过,从而导致焦点细分质硬化 (FSGS) 和末期病 (ESKD).
- 降低脑膜内压力的药物被假设在切术后对脏结果产生保护作用.
- SARS-CoV-2 (COVID-19) 感染对这些结果的影响仍在调查中.
研究的目的:
- 为了研究降低内压力的药物对功能和单边切除术后疾病进展的影响.
- 为了检查COVID-19感染对经过单边切除术的患者的结果的影响.
主要方法:
- 国家临床队列协作 (N3C) COVID-19 Enclave数据库的分析.
- 用多变量线性回归来评估结果,包括估计的膜过率 (eGFR) 在腎切除术后长达3年的时间.
- 评估的具体结果包括ESKD,高血压 (HTN),FSGS和痛风的发生.
主要成果:
- 在非COVID-19患者中,单独使用ACE抑制剂/ARB与降低EGFR相关,而单独使用SGLT2抑制剂与增加EGFR相关.
- 同时使用ACE抑制剂/ARB和SGLT2抑制剂并没有显著改变eGFR趋势.
- COVID-19感染与腎切除術后ESKD,FSGS和痛風的風險較高有關.
结论:
- RAS封锁对FSGS发生率没有显著影响.
- 在SGLT2抑制的过程中,经切除术后的eGFR表现出了有利的趋势.
- 这项研究受到SGLT2抑制剂使用和FSGS的患者缺席的限制.
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