慢性肾病:煤矿里的金丝雀

P. Holmes
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摘要

慢性肾脏疾病是一种常见的疾病,治疗费用很高。大部分费用与晚期肾脏疾病和相关的心血管疾病有关。幸运的是,现在有几种治疗方法不仅可以减缓慢性肾脏疾病的进展,还可以减少心血管疾病发病率和死亡率的负担。为了有效地做到这一点,患者需要尽早得到诊断,只有这样才能部署最佳的预防措施,包括生活方式和药物。随着慢性肾脏疾病的规模和复杂性,越来越需要及时获得专科护理。转诊标准发生了变化,通过使用四变量肾衰竭风险方程,更多地关注发展为终末期肾脏疾病的5年风险。慢性肾病患者有效治疗的主要限制之一是高钾血症。适当的高钾血症检测、评估和管理频率不仅有助于降低死于该疾病的风险,还有助于降低死于慢性肾脏疾病和心力衰竭的风险,因为肾素-血管紧张素-醛固酮系统抑制剂的次优治疗往往会损害最佳护理。慢性肾脏疾病常见于初级保健。帕特里克·霍尔姆斯着眼于疾病的识别和最佳管理
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Chronic kidney disease: the canary in the coal mine
Chronic kidney disease is a common condition that is costly to manage. Most of the costs are linked with advanced kidney disease and the associated cardiovascular disease. Fortunately, there are now several treatments that can not only slow the progression of chronic kidney disease but also reduce the burden of cardiovascular morbidity and mortality. To do this effectively, patients need to be diagnosed as early as possible, as only then can optimal preventative measures, both lifestyle and pharmaceutical, be deployed. With the scale and complexity of chronic kidney disease, timely access to specialist care is increasingly required. Referral criteria have changed, with more focus on the 5-year risk of developing end-stage renal disease by using the four variable kidney failure risk equation. One of the major limitations to the effective treatment of people living with chronic kidney disease is hyperkalaemia. The appropriate frequency of testing, assessment and management of hyperkalaemia helps not only reduce the risk of dying from the condition, but also from chronic kidney disease and heart failure, as too often sub-optimal treatment with renin-angiotensin-aldosterone system inhibitors impairs optimal care. Chronic kidney disease is commonly seen in primary care. Patrick Holmes looks at identification and optimal management of the condition
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