{"title":"降低同型半胱氨酸干预慢性肾脏疾病。","authors":"Shirinsadat Badri, Sahar Vahdat, Shiva Seirafian, Morteza Pourfarzam, Tahereh Gholipur-Shahraki, Sara Ataei","doi":"10.4103/jrpp.jrpp_75_21","DOIUrl":null,"url":null,"abstract":"<p><p>The incidence of cardiovascular events and mortality is higher in patients with chronic kidney disease (CKD) compared to the general population. Homocysteine (Hcy) appears to be an independent risk factor for cardiovascular diseases in general populations and patients with CKD. Further, hyperhomocysteinemia can cause endothelial damage and increase the activity and production of coagulation factors, and its prevalence among patients with end-stage renal disease is approximately 85%-100%. Most treatments, which lower Hcy levels and have been considered in previous studies, include folic acid, B vitamins, omega-3 fatty acids, and N-acetylcysteine. However, the effect of therapies that can decrease Hcy levels and thus cardiovascular events in these patients is still unclear. The results are conflicting and require further investigation. To guide treatment decisions and improve patient outcomes, multiple databases were searched, including Web of Science, PubMed, and Medline to summarize the available evidence (i.e., clinical trial and meta-analyses) on Hcy-lowering interventions and cardiovascular events.</p>","PeriodicalId":17158,"journal":{"name":"Journal of Research in Pharmacy Practice","volume":"10 3","pages":"114-124"},"PeriodicalIF":0.8000,"publicationDate":"2021-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/53/JRPP-10-114.PMC8809459.pdf","citationCount":"6","resultStr":"{\"title\":\"Homocysteine-Lowering Interventions in Chronic Kidney Disease.\",\"authors\":\"Shirinsadat Badri, Sahar Vahdat, Shiva Seirafian, Morteza Pourfarzam, Tahereh Gholipur-Shahraki, Sara Ataei\",\"doi\":\"10.4103/jrpp.jrpp_75_21\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The incidence of cardiovascular events and mortality is higher in patients with chronic kidney disease (CKD) compared to the general population. Homocysteine (Hcy) appears to be an independent risk factor for cardiovascular diseases in general populations and patients with CKD. Further, hyperhomocysteinemia can cause endothelial damage and increase the activity and production of coagulation factors, and its prevalence among patients with end-stage renal disease is approximately 85%-100%. Most treatments, which lower Hcy levels and have been considered in previous studies, include folic acid, B vitamins, omega-3 fatty acids, and N-acetylcysteine. However, the effect of therapies that can decrease Hcy levels and thus cardiovascular events in these patients is still unclear. The results are conflicting and require further investigation. To guide treatment decisions and improve patient outcomes, multiple databases were searched, including Web of Science, PubMed, and Medline to summarize the available evidence (i.e., clinical trial and meta-analyses) on Hcy-lowering interventions and cardiovascular events.</p>\",\"PeriodicalId\":17158,\"journal\":{\"name\":\"Journal of Research in Pharmacy Practice\",\"volume\":\"10 3\",\"pages\":\"114-124\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2021-12-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/53/JRPP-10-114.PMC8809459.pdf\",\"citationCount\":\"6\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Research in Pharmacy Practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/jrpp.jrpp_75_21\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/7/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Research in Pharmacy Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/jrpp.jrpp_75_21","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/7/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 6
摘要
与一般人群相比,慢性肾脏疾病(CKD)患者的心血管事件发生率和死亡率更高。同型半胱氨酸(Hcy)似乎是普通人群和CKD患者心血管疾病的独立危险因素。此外,高同型半胱氨酸血症可引起内皮损伤,增加凝血因子的活性和产生,其在终末期肾病患者中的患病率约为85%-100%。大多数降低Hcy水平的治疗方法包括叶酸、B族维生素、omega-3脂肪酸和n -乙酰半胱氨酸。然而,在这些患者中降低Hcy水平和心血管事件的治疗效果仍不清楚。结果是相互矛盾的,需要进一步调查。为了指导治疗决策和改善患者预后,我们检索了多个数据库,包括Web of Science、PubMed和Medline,以总结关于降低hcy干预和心血管事件的现有证据(即临床试验和荟萃分析)。
Homocysteine-Lowering Interventions in Chronic Kidney Disease.
The incidence of cardiovascular events and mortality is higher in patients with chronic kidney disease (CKD) compared to the general population. Homocysteine (Hcy) appears to be an independent risk factor for cardiovascular diseases in general populations and patients with CKD. Further, hyperhomocysteinemia can cause endothelial damage and increase the activity and production of coagulation factors, and its prevalence among patients with end-stage renal disease is approximately 85%-100%. Most treatments, which lower Hcy levels and have been considered in previous studies, include folic acid, B vitamins, omega-3 fatty acids, and N-acetylcysteine. However, the effect of therapies that can decrease Hcy levels and thus cardiovascular events in these patients is still unclear. The results are conflicting and require further investigation. To guide treatment decisions and improve patient outcomes, multiple databases were searched, including Web of Science, PubMed, and Medline to summarize the available evidence (i.e., clinical trial and meta-analyses) on Hcy-lowering interventions and cardiovascular events.
期刊介绍:
The main focus of the journal will be on evidence-based drug-related medical researches (with clinical pharmacists’ intervention or documentation), particularly in the Eastern Mediterranean region. However, a wide range of closely related issues will be also covered. These will include clinical studies in the field of pharmaceutical care, reporting adverse drug reactions and human medical toxicology, pharmaco-epidemiology and toxico-epidemiology (poisoning epidemiology), social aspects of pharmacy practice, pharmacy education and economic evaluations of treatment protocols (e.g. cost-effectiveness studies). Local reports of medication utilization studies at hospital or pharmacy levels will only be considered for peer-review process only if they have a new and useful message for the international pharmacy practice professionals and readers.