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中华肾病研究电子杂志 ›› 2013, Vol. 02 ›› Issue (01) : 1 -4. doi: 10.3877/cma.j.issn.2095-3216.2013.01.001

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慢性肾脏病临床实践中应注意防止分期体系的负面影响
郑法雷1,()   
  1. 1.100730 北京协和医院肾内科
  • 出版日期:2013-02-15
  • 通信作者: 郑法雷

Noting to prevent the negative impact of the staging system during the clinical practice of the chronic kidney disease

Fa-lei ZHENG1,()   

  1. 1.Department of Nephrology, Chinese Academy of Medical Sciences and Beijing Union Medical College Hospital, Beijing 100730, China
  • Published:2013-02-15
  • Corresponding author: Fa-lei ZHENG
引用本文:

郑法雷. 慢性肾脏病临床实践中应注意防止分期体系的负面影响[J/OL]. 中华肾病研究电子杂志, 2013, 02(01): 1-4.

Fa-lei ZHENG. Noting to prevent the negative impact of the staging system during the clinical practice of the chronic kidney disease[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2013, 02(01): 1-4.

改善全球肾脏病预后(KDIGO)专家组3 年前对慢性肾脏病(CKD)分期方法做了新的修改。修改后的CKD 分期系统已有了显著改进,但在CKD 分期系统的认知上,目前尚有不少需要解决的难点与问题。在实践中探讨这些难点与问题的解决办法,包括改进估算肾小球滤过率(eGFR)计算公式,完善CKD分期标准,防止CKD 3期过多诊断、老年人CKD的过度诊断、对CKD病变程度估计过重等,努力做到既坚持积极早期筛查,又能够严谨慎重作出诊断,及时把握CKD治疗的有利时机。不断解决这些难点,逐步建立一套科学合理又便于应用的CKD分期体系和评估方法,对提高CKD诊断水平和改进临床治疗现状均有帮助。

The classification system for chronic kidney disease (CKD) was modified by the Kidney Disease: Improving Global Outcomes (KDIGO) three years ago. The revised system is better than before. However, there are some points to be resolved in understanding and applying the classification system. These points include improving equation of estimating glomerular filtration rate (GFR), optimizing the criteria of CKD classification, avoidance of over-diagnosis of CKD stage 3 especially in the elderly,and keeping away from over-valuation of severity of CKD. We should do our best to screen the patients as early as possible, make diagnosis of CKD very carefully, and treat the patients in time. It will be very helpful to establish the CKD classification and evaluation system more scientifically and rationally for improvements of CKD diagnosis and management.

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