Takeda Tetsuro, Gejyo Fumitake
Division of Clinical Nephrology and Rheumatology, Niigata University Hospital.
Nihon Rinsho. 2007 Sep;65(9):1727-33.
Chronic kidney disease (CKD) is increasingly recognized not only as a cause of end-stage renal disease but also as a cause of cardiovascular disease. Importantly, it is intimately associated with non-healthy lifestyles such as obesity, metabolic syndrome, hypertension, diabetes mellitus, smoking, and heavy drinking. To define CKD direct measurement of GFR or estimation of GFR (eGFR) is required. Japan Society of Nephrology is asking nationwide project to create "original" equation without using ethnic factor to obtain eGFR. Early detection and early treatment are vital to prevent not only CKD progression but also cardiovascular events. A comprehensive health education campaign and screening of the general populace are needed in order to detect CKD early. The control of hypertension, dyslipidemia, proteinuria, obesity, are intervention strategies that retard or prevent progression of CKD. Blockade of the renin-angiotensin system can be beneficial, especially if proteinuria is present.
慢性肾脏病(CKD)不仅越来越被认为是终末期肾病的病因,也是心血管疾病的病因。重要的是,它与肥胖、代谢综合征、高血压、糖尿病、吸烟和酗酒等不健康的生活方式密切相关。要定义CKD,需要直接测量肾小球滤过率(GFR)或估算GFR(eGFR)。日本肾脏病学会正在开展全国性项目,以创建不使用种族因素来获得eGFR的“原创”方程。早期检测和早期治疗对于预防CKD进展以及心血管事件都至关重要。为了早期发现CKD,需要开展全面的健康教育活动并对普通民众进行筛查。控制高血压、血脂异常、蛋白尿、肥胖是延缓或预防CKD进展的干预策略。肾素-血管紧张素系统的阻断可能有益,尤其是在存在蛋白尿的情况下。