使用 RenalGuard® 系统对急性失代偿性心力衰竭住院患者进行利尿治疗,并对治疗效果好和不好的患者进行特征分析--初步研究。

Paweł Siwołowski, Piotr Gajewski, Mateusz Sokolski, Robert Zymliński, Mateusz Guzik, Joanna Szachniewicz, Piotr Ponikowski
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引用次数: 0

摘要

研究背景本研究的目的是分析利尿剂反应、临床特征和选定生化指标浓度之间的潜在关系,并确定哪些患者将从结合标准利尿剂疗法和使用 RenalGuard® 系统的新疗法中受益:这是一项回顾性研究,研究对象是 19 名因急性失代偿性心力衰竭(ADHF,NYHA III-IV 级,血压 125 ± 14/73 ± 16 mmHg,eGFR 58 ± 24)住院的患者(平均年龄 67 ± 10 岁,95% 为男性),尽管接受了标准治疗,但仍存在持续的过度水化现象。对选定的临床和生化参数进行了有针对性的比较分析,以确定与较好的利尿剂反应相关的参数[良好利尿剂反应者(GDR)组]:结果:利尿剂反应良好组的肌酐(1.23 ± 0.4 vs. 1.69 ± 0.35,p = 0.025)、镁(0.70 ± 0.14 vs. 0.83 ± 0.09,p = 0.030)和血尿素氮(BUN,28 ± 11 vs. 39 ± 10,p = 0.045)水平明显较低。此外,GDR 组在治疗的第 12 小时和第 24 小时稀释尿液的能力显著提高,具有统计学意义:研究结果表明,RenalGuard® 系统可与标准静脉利尿剂疗法相结合,用于治疗部分 ADHF 患者,以控制脱水。最好能确定 GDR 的详细机制,并更准确地描述这类患者的特征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diuretic treatment using the RenalGuard® system in patients hospitalized due to acute decompensated heart failure and characterization of the profile of patients with good and poor response to treatment - preliminary study.

Background: The aim of the study was to analyze the potential relationship between the diuretic response, the clinical profile and the concentrations of selected biochemical markers and to identify a group of patients who will benefit from a new form of therapy combining standard diuretic therapy with the use of a RenalGuard® system.

Methods: This is a retrospective study of 19 patients (mean age 67 ± 10 years, 95% men) hospitalized due to acute decompensated heart failure (ADHF, NYHA class III-IV, BP 125 ± 14/73 ± 16 mmHg, eGFR 58 ± 24) with persistent overhydration despite standard therapy. A targeted comparative analysis of selected clinical and biochemical parameters was performed to determine the parameters associated with a better diuretic response [good diuretic responders (GDR) group].

Results: The good diuretic responders group had significantly lower levels of creatinine (1.23 ± 0.4 vs. 1.69 ± 0.35, p = 0.025) magnesium 0.70 ± 0.14 vs. 0.83 ± 0.09, p = 0.030) and blood urea nitrogen (BUN, 28 ± 11 vs. 39 ± 10, p = 0.045). Additionally, in GDR group a statistically significant greater ability to dilute urine in the 12th and 24th hour of therapy was found.

Conclusions: The results of the study indicate the potential use of the RenalGuard® system in combination with standard intravenous diuretic therapy for controlled dehydration in the treatment of a selected group of patients with ADHF. It is advisable to identify the detailed mechanisms of GDR and characterize this group of patients more precisely.

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