切换至 "中华医学电子期刊资源库"

中华肾病研究电子杂志 ›› 2014, Vol. 03 ›› Issue (05) : 229 -232. doi: 10.3877/cma.j.issn.2095-3216.2014.05.001

述评

重视慢性肾脏病的药物治疗与合理用药
郑法雷1,()   
  1. 1.100730 中国医学科学院北京协和医院肾内科
  • 出版日期:2014-10-15
  • 通信作者: 郑法雷

Drug treatment and rational use in chronic kidney disease

Falei Zheng1,()   

  1. 1.Department of Nephrology,Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
  • Published:2014-10-15
  • Corresponding author: Falei Zheng
引用本文:

郑法雷. 重视慢性肾脏病的药物治疗与合理用药[J/OL]. 中华肾病研究电子杂志, 2014, 03(05): 229-232.

Falei Zheng. Drug treatment and rational use in chronic kidney disease[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2014, 03(05): 229-232.

药物治疗是慢性肾脏病(CKD)患者的主要治疗手段之一。 药物治疗,应当强调早期、综合、可持续性及个体化防治等原则。 同时,要重视CKD 患者的药代动力学和药效动力学可能发生的变化。 尤其是在肾小球滤过滤(GFR)中重度下降(CKD 3b ~5 期)时,以及CKD 5 期患者应用透析治疗时,患者的药代动力学变化则更为显著;此时多种药物的剂量可能需进行适当调整,大多数需要减量,以保证药物的安全性与疗效。

Drug therapy is one of the most important managements for patients with chronic kidney disease (CKD). It should be emphasized that drug treatment be applied early, synthetically, sustainably,and individually. Attention should also be paid to the changes in pharmacokinetics and pharmacodynamics of drug in CKD patients. The drug pharmacokinetics change was especially significant in CKD patients with moderate-to-severe decrease of glomerular filtration rate (GFR) (CKD stage 3b-5), and in CKD stage 5 patients undergoing dialysis therapy, when dosages of many drugs may need to be adjusted, most of which should be reduced, in order to assure both safety and efficacy of the drugs used.

1
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Chapter 3: Management of progression and complications of CKD. Kidney Int, 2013, Suppl 3(1):73-90.
2
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Chapter 4: Other complications of CKD: CVD, medication dosage, patient safety,infections, hospitalizations, and caveats for investigating complications of CKD. Kidney Int,2013, Suppl 3(1):91-111.
3
Turner JM, Bauer C, Abramowitz MK, et al. Treatment of chronic kidney disease. Kidney Int,2012,81(4):351-362.
4
Rivas Velasquez KM, Hames E, Masri H. Evaluation and management of the older adult with chronic kidney disease[J]. Prim Care,2014,41(4):857-874.
5
Ross S, Benz K, Sauerstein K, et al. Unexpected recovery from longterm renal failure in severe diffuse proliferative lupus nephritis[J]. BMC Nephrol,2012,13:81.
6
Tampe D,Zeisberg M. Potential approaches to reverse or repair renal fibrosis[J]. Nat Rev Nephrol,2014,10(4):226-237.
7
Brater DC. Drug dosing in patients with impaired renal function[J].Clin Pharmacology & Therapeutics,2009,86(5):483-489.
8
Khanal A, Castelino RL, Peterson GM, et al. Dose adjustment guidelines for medications in patients with renal impairment: how consistent are drug information sources[J]? Intern Med J,2014,44(1):77-85.
[1] 史学兵, 谢迎东, 谢霓, 徐超丽, 杨斌, 孙帼. 声辐射力弹性成像对不可切除肝细胞癌门静脉癌栓患者放射治疗效果的评价[J/OL]. 中华医学超声杂志(电子版), 2024, 21(08): 778-784.
[2] 易柏成, 李旭光, 王容容, 王新璇. 数字化3D打印导板应用于上前牙钙化根管治疗2例[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(06): 385-390.
[3] 严华悦, 刘子祥, 周少波. 磷酸烯醇式丙酮酸羧激酶-1在恶性肿瘤中的研究进展[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 452-456.
[4] 高俊颖, 张海洲, 区泓乐, 孙强. FOLFOX-HAIC 为基础的肝细胞癌辅助转化治疗的应用进展[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 457-463.
[5] 李华志, 曹广, 刘殿刚, 张雅静. 不同入路下行肝切除术治疗原发性肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 52-55.
[6] 陈浩, 王萌. 胃印戒细胞癌的临床病理特征及治疗选择的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 108-111.
[7] 梁孟杰, 朱欢欢, 王行舟, 江航, 艾世超, 孙锋, 宋鹏, 王萌, 刘颂, 夏雪峰, 杜峻峰, 傅双, 陆晓峰, 沈晓菲, 管文贤. 联合免疫治疗的胃癌转化治疗患者预后及术后并发症分析[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 619-623.
[8] 刘柏隆, 周祥福. 压力性尿失禁阶梯治疗的项目介绍[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 125-125.
[9] 刘柏隆. 女性压力性尿失禁阶梯治疗之手术治疗方案选择[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 126-126.
[10] 中华医学会器官移植学分会. 肝移植术后缺血性胆道病变诊断与治疗中国实践指南[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 739-748.
[11] 陈伟杰, 何小东. 胆囊癌免疫靶向治疗进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 763-768.
[12] 王誉英, 刘世伟, 王睿, 曾娅玲, 涂禧慧, 张蒲蓉. 老年乳腺癌新辅助治疗病理完全缓解的预测因素分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 641-646.
[13] 崔军威, 蔡华丽, 胡艺冰, 胡慧. 亚甲蓝联合金属定位夹及定位钩针标记在乳腺癌辅助化疗后评估腋窝转移淋巴结的临床应用价值探究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 625-632.
[14] 张平骥, 徐钰, 李天水, 庞文翼, 符师宁, 张梦圆. 重症患者镇静治疗现状及期望的调查研究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 562-567.
[15] 王昌前, 林婷婷, 宁雨露, 王颖杰, 谭文勇. 光免疫治疗在肿瘤领域的临床应用新进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 575-583.
阅读次数
全文


摘要