蛋白尿对血液透析患者功能残留的有害影响
Beatriz Sánchez Alamo1, Irene Minguez1, Martha Elisabeth Díaz Domínguez1
1Department of Nephrology, Hospital Universitario Ramón y Cajal. IRYCIS, Madrid, Spain.
概括
在血液透析开始时,脏范围蛋白尿预测了残留功能更快地丧失. 早期识别高蛋白尿症患者可以指导个性化策略,以保持功能和改善结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 腎臟醫學 腎臟醫學
背景情况:
- 剩余功能 (RKF) 对血液透析 (HD) 患者的结果至关重要.
- 蛋白尿在HD发病时的RKF下降中的作用尚未完全理解.
研究的目的:
- 为了评估基线蛋白尿和在HD的第一年RKF损失之间的关联.
- 为了确定RKF下降的预后标志物在事件的HD患者.
主要方法:
- 对发生在线HDF患者的前性研究,这些患者有保存的RKF (脏尿素清除率≥2.5mL/分钟,尿液输出>500mL/天).
- 主要终点:一年后发生RKF损失 (脏尿素清除率<2.5毫升/分钟).
- 蛋白尿症通过24小时尿中蛋白质分泌和尿中蛋白质与肌素的比率来评估.
主要成果:
- 脏范围蛋白尿 (≥3.5g/24h) 与RKF下降的风险显著增加有关 (HR=2.04,P=0.04).
- 患有高蛋白尿症的患者更早达到RKF损失.
- 在患有脏范围蛋白尿症的患者中观察到升高的β2-微型球蛋白水平.
结论:
- 脏范围蛋白尿独立预测HD患者的加速RKF损失和无尿.
- 蛋白尿是RKF下降的有价值的预后标志物.
- 针对高蛋白尿症患者的个性化策略可以保持RKF并改善结果.
相关概念视频
Hemodialysis II: Procedure and Complications
1.5K
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
1.5K
Dialysis
1.8K
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).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
1.8K
Dialysis
2.1K
Dialysis is a diffusion-based purification process that separates analyte molecules from a complex matrix. This is accomplished by allowing molecules in the solution to pass through a semipermeable membrane into a liquid on the other side. The membrane is usually made of cellulose acetate or cellulose nitrate, and the second liquid must be miscible with the solution. Ions (e.g., chloride or sodium) or organic molecules (e.g., glucose) can pass through the membrane pores, which generally have...
2.1K
Chronic Kidney Disease III: Interprofessional Care
578
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
578
Acute Kidney Injury V: Interprofessional Care
445
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
445
Factors Affecting Renal Clearance: Renal Impairment
538
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...
538


