Association between Acute Declines in eGFR during Renin-Angiotensin System Inhibition and Risk of Adverse Outcomes.

IF 10.3 1区 医学 Q1 UROLOGY & NEPHROLOGY Journal of The American Society of Nephrology Pub Date : 2024-10-01 Epub Date: 2024-06-18 DOI:10.1681/ASN.0000000000000426
Elaine Ku, Hocine Tighiouart, Charles E McCulloch, Lesley A Inker, Ogechi M Adingwupu, Tom Greene, Raymond O Estacio, Mark Woodward, Dick de Zeeuw, Julia B Lewis, Thierry Hannedouche, Fan Fan Hou, Tazeen H Jafar, Enyu Imai, Giuseppe Remuzzi, Hiddo J L Heerspink, Robert D Toto, Mark J Sarnak
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肾素-血管紧张素系统抑制过程中估计肾小球滤过率的急性下降与不良后果风险之间的关系。
背景:开始使用肾素-血管紧张素系统(RAS)抑制剂时,肾小球滤过率(GFR)通常会下降。我们的目的是确定 RAS 抑制试验期间估计 GFR 下降与肾脏结果之间的关系:我们纳入了患有慢性肾脏病(估计 GFRR)的参与者:11,800 人的平均 eGFR 为 43 (SD 11) mL/min/1.73m2 ,中位尿白蛋白/肌酐比值为 362 mg/g(IQR 为 50,1367),其中 1,162 人(10%)出现肾衰竭。据估计,肾衰竭患者开始使用RAS抑制剂后,eGFR下降的阈值在3个月内可达13%(95%CI为8%,17%),在1个月内可达21%(95%CI为15%,27%):结论:在接受RAS抑制剂治疗的患者中,与使用安慰剂或其他药物时eGFR无下降相比,eGFR在3个月内下降≤13%或在1个月内下降≤21%与较低的肾衰竭风险相关。
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来源期刊
Journal of The American Society of Nephrology
Journal of The American Society of Nephrology 医学-泌尿学与肾脏学
CiteScore
22.40
自引率
2.90%
发文量
492
审稿时长
3-8 weeks
期刊介绍: The Journal of the American Society of Nephrology (JASN) stands as the preeminent kidney journal globally, offering an exceptional synthesis of cutting-edge basic research, clinical epidemiology, meta-analysis, and relevant editorial content. Representing a comprehensive resource, JASN encompasses clinical research, editorials distilling key findings, perspectives, and timely reviews. Editorials are skillfully crafted to elucidate the essential insights of the parent article, while JASN actively encourages the submission of Letters to the Editor discussing recently published articles. The reviews featured in JASN are consistently erudite and comprehensive, providing thorough coverage of respective fields. Since its inception in July 1990, JASN has been a monthly publication. JASN publishes original research reports and editorial content across a spectrum of basic and clinical science relevant to the broad discipline of nephrology. Topics covered include renal cell biology, developmental biology of the kidney, genetics of kidney disease, cell and transport physiology, hemodynamics and vascular regulation, mechanisms of blood pressure regulation, renal immunology, kidney pathology, pathophysiology of kidney diseases, nephrolithiasis, clinical nephrology (including dialysis and transplantation), and hypertension. Furthermore, articles addressing healthcare policy and care delivery issues relevant to nephrology are warmly welcomed.
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