Disease-Modifying Antirheumatic Drug Therapy of Inflammatory Rheumatic Diseases in End-Stage Kidney Disease.

IF 2.3 4区医学 Q2 PERIPHERAL VASCULAR DISEASE

Kidney & blood pressure research Pub Date : 2025-01-01 Epub Date: 2025-03-06 DOI:10.1159/000544810

Daniel Patschan, Igor Matyukhin, Friedrich Stasche, Oliver Ritter, Susann Patschan

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引用次数: 0

Abstract

Background: Inflammatory rheumatic diseases regularly require the use of disease-modifying antirheumatic drugs (DMARDs). The use of DMARDs in patients with end-stage chronic kidney disease (CKD stage 5D) is particularly challenging due to the lack of systematic studies available for this patient population. This narrative review aimed to address the aspect of DMARD therapy in CKD 5D.

Summary: The current article is a narrative review. References were sourced from the following databases: PubMed, Web of Science, Cochrane Library, and Scopus. The search period spanned from 1975 to 2024. There is a notable lack of systematic data on this topic. The available literature was reviewed to provide insights, despite the limited availability of comprehensive studies. Individuals with terminal kidney disease can presumably be safely treated with leflunomide, mycophenolic acid, sulfasalazine, azathioprine, belimumab, and anti-CD20. For all other substances, there are either significant restrictions, insufficient data, or inadequate experience.

Key messages: Some conventional and biologic DMARDs are available for the management of inflammatory rheumatic diseases in CKD stage 5D. It is essential to consider the limitations on kidney function, as they can significantly affect the pharmacokinetics of medications. Consequently, slightly more frequent checkups are recommended when using the defined preparations.

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终末期肾病炎性风湿病的DMARD治疗。

炎症性风湿病通常需要使用改善疾病的抗风湿药（DMARDs）。由于缺乏针对这一患者群体的系统研究，在终末期慢性肾病（CKD期5D）患者中使用dmard尤其具有挑战性。本文综述了DMARD在ckd5d治疗中的应用。本文是一篇叙述性的综述。参考文献来自以下数据库：PubMed， Web of Science， Cochrane Library和Scopus。搜索期从1975年到2024年。关于这一主题明显缺乏系统的数据。尽管全面研究的可用性有限，但对现有文献进行了回顾以提供见解。晚期肾病患者可以安全地使用来氟米特、霉酚酸、磺胺嘧啶、硫唑嘌呤、贝利姆单抗和抗cd20治疗。对于所有其他物质，要么有重大限制，要么数据不足，要么经验不足。一些传统和生物dmard可用于CKD 5D期炎症性风湿病的治疗。-必须考虑肾功能的限制，因为它们会显著影响药物的药代动力学。-因此，建议在使用规定的制剂时进行更频繁的检查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kidney & blood pressure research 医学-泌尿学与肾脏学

CiteScore

4.80

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal comprises both clinical and basic studies at the interface of nephrology, hypertension and cardiovascular research. The topics to be covered include the structural organization and biochemistry of the normal and diseased kidney, the molecular biology of transporters, the physiology and pathophysiology of glomerular filtration and tubular transport, endothelial and vascular smooth muscle cell function and blood pressure control, as well as water, electrolyte and mineral metabolism. Also discussed are the (patho)physiology and (patho) biochemistry of renal hormones, the molecular biology, genetics and clinical course of renal disease and hypertension, the renal elimination, action and clinical use of drugs, as well as dialysis and transplantation. Featuring peer-reviewed original papers, editorials translating basic science into patient-oriented research and disease, in depth reviews, and regular special topic sections, ''Kidney & Blood Pressure Research'' is an important source of information for researchers in nephrology and cardiovascular medicine.