[肾脏疾病:来自 KDIGO 指南的新闻]。

Deutsche medizinische Wochenschrift (1946) Pub Date : 2024-08-01 Epub Date: 2024-08-15 DOI:10.1055/a-2145-7564
Markus Ketteler
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引用次数: 0

摘要

KDIGO 2024 更新版还补充了新的 "临床实践要点",这些要点来自于当前的证据,但并不一定经过前瞻性对照研究的全面证实。针对狼疮性肾炎的《2024 年更新版》中最重要的变化涉及狼疮性肾炎 III 级和 IV 级的诱导治疗建议。其基础仍然是大剂量糖皮质激素治疗和使用羟氯喹。2024 年更新版中关于 ANCA 相关性肾炎的两个新进展是基于对使用 C5a 受体抑制剂 Avacopan 的研究,以及关于减少糖皮质激素用量的诱导方案的越来越多的数据。由于在实践中进行血压测量的条件不一致且多变,因此发布了一份国际共识声明,其中规定了 4 个步骤,以实现测量结果的充分有效性。2023 年 CKD-MBD 争议会议:在 2023 年争议会议上讨论的 CKD-MBD 的更新正在进行中,尚未发布。不过,2023 年数据与 2017 年指南之间并无严重矛盾--有关含钙磷酸盐结合剂的风险评估可能已被纳入视野。
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[Kidney diseases: News from the KDIGO guidelines].

The KDIGO Update 2024 was supplemented by new "Clinical Practice Points", which were derived from the current evidence but are not necessarily comprehensively proven by prospective controlled studies. The most significant change in the Update 2024 for Lupus nephritis concerns the recommendations for induction therapy for lupus nephritis classes III and IV. The basis is still high-dose glucocorticoid treatment and the use of hydroxychloroquine. The 2 new developments in the 2024 Update concerning ANCA-associated nephritis are based on the studies on the use of the C5a receptor inhibitor Avacopan and the increasing data on induction protocols with reduced glucocorticoid dosage. Due to the inconsistency and variability of the conditions under which blood pressure measurements are carried out in practice, an international consensus statement was issued which defines 4 steps to achieve sufficient validity of the measurement results. CKD-MBD Controversies Conference 2023: The update for CKD-MBD, which was discussed in the Controversies Conference 2023, is in progress and has not been released yet. However, there were no serious contradictions between the 2023 data and the 2017 guidelines - the risk assessment regarding calcium-containing phosphate binders may have been put into perspective.

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