在脏疾病中停止宁- ангиотензин- алдостерон系统抑制剂
Eva Glenn Lecea1, Krystle Frazier1, Elaine Ku1,2
1University of California, San Francisco, Department of Pediatrics.
Current opinion in nephrology and hypertension
|March 14, 2026
概括
在慢性病 (CKD) 中停止使用胺-血管酶系统抑制剂 (RASi) 没有为脏或生存带来好处,并且与更糟糕的结果有关. 在急性损伤 (AKI) 或高血症后重新启动RASi可以改善存活率并减缓病的进展.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 病:改善全球结果 (KDIGO) 准则倡导慢性病 (CKD) 中使用氨酸 - 血管激素系统抑制剂 (RASi),因为和心血管的优势.
- 现实世界的证据表明,在CKD患者中,RASi利用率低于最佳,并且经常停止治疗.
研究的目的:
- 审查与在患有慢性病,高胆血症和急性损伤 (AKI) 的患者中中止RASi相关的临床结果.
主要方法:
- 对试验级和观察数据的系统审查.
- 在特定患者队列中,分析与RASi停药与继续治疗相关的结果.
主要成果:
- 停用RASi在患有低估计膜过率 (eGFR) 的CKD患者中,不会改善脏或死亡的结果.
- 在外科手术期间继续RASi的结果与停止治疗的结果相似.
- 在AKI和高血症后重新启动RASi与提高生存率和减少CKD进展有关.
结论:
- 在CKD,高血和AKI的背景下停止RASi通常与不良的临床结果有关.
- 维持或重新启动RASi治疗可能对患有CKD,高胆血症和AKI的患者有益.
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