降低血清尿酸度尽管没有改变的阿洛普林醇剂量在开始透析的痛风患者:回顾性图表审查
Noha Kamel1,2, Ronald Castelino1,3, Daniel Wright1,4,5
1School of Pharmacy, Faculty of Medicine & Health, The University of Sydney, New South Wales, Australia.
透析可显著降低血清尿酸的水平,在功能衰竭的患者在阿洛普林醇. 剂量可能需要调整,可能需要停止处方,以避免治疗不足并有效管理痛风.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 类风湿病学 类风湿病学
- 临床药理学 临床药理学
背景情况:
- 患有功能衰竭的患者面临高风险的痛风住院和死亡.
- 透析可以改善尿酸的去除,并降低氧普林醇水平,但其对达到适用于痛风治疗的血清尿酸度目标 (<0.36 mmol/L) 的影响尚不清楚.
研究的目的:
- 在开始透析后评估脏衰竭患者的血清尿酸度.
- 评估透析对阿洛普林醇剂量策略对痛风管理的影响.
主要方法:
- 在澳大利亚的一个透析中心处方Allopurinol的成年患者的回顾性图表审查 (01/06/2019 - 30/06/2024).
- 数据包括人口统计,透析方式,阿洛普林醇剂量和血清尿酸盐水平在透析开始前和之后 (长达5年).
主要成果:
- 分析了45名患者 (18名血液透析,27名腹腔透析).
- 在透析开始后,血清尿酸水平显著下降 (HD:0.51至0.31毫摩尔/升;PD:0.53至0.33毫摩尔/升) 在不变的阿洛普林醇剂量下.
- 60%的HD患者和78%的PD患者至少一次达到尿酸度的目标.
结论:
- 透析独立地有助于显著的血清尿酸减少功能衰竭患者.
- 氨醇剂量需要在透析开始后重新评估,并考虑在达到目标尿酸水平的患者中取消处方.
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