KFH Nierenzentrum Muenchen Laim, Elsenheimerstrasse 63, D-80687 Munich, Germany.
Expert Opin Pharmacother. 2010 Mar;11(4):597-613. doi: 10.1517/14656560903544494.
The incidence and prevalence of end-stage renal disease (ESRD) requiring renal replacement therapy (RRT) continues to grow worldwide. ESRD causes significant morbidity and mortality and has enormous financial and personal costs.
Major electronic databases (including the Cochrane Library, MEDLINE and EMBASE) were searched from 1989 to September 2009 to summarize current pharmacotherapy of ESRD-associated complications in adults receiving maintenance dialysis (hemodialysis or continuous ambulatory peritoneal dialysis). Current guidelines for the treatment of ESRD (e.g., NKF-K/DOQI, KDIGO, and the ERA-EDTA's European Renal Best Practice Guidelines) were included.
Commonly used pharmacological treatment strategies for chronic arterial hypertension, anemia, iron management, dyslipidemia, hyperglycemia, and for disturbances of bone and mineral metabolism, including hyperphosphatemia and secondary hyperparathyroidism in ESRD, are presented. In addition, the reader will learn that nonadherence to oral medication in ESRD can contribute significantly to excess morbidity and mortality of the dialysis population.
Improvements in pharmacotherapy of ESRD may be at least in part counteracted by continuously increasing age and comorbid disease of the dialysis population. Individualized and tailor-made pharmacological management of the ESRD patient remains a challenge for the future.
终末期肾病（ESRD）的发病率和患病率需要肾脏替代治疗（RRT）在世界范围内继续增长。 ESRD 会导致严重的发病率和死亡率，并带来巨大的财务和个人成本。
从 1989 年到 2009 年 9 月，主要电子数据库（包括 Cochrane 图书馆，MEDLINE 和 EMBASE）进行了搜索，以总结接受维持性透析（血液透析或持续不卧床腹膜透析）的成人 ESRD 相关并发症的当前药物治疗。包括 ESRD 治疗的当前指南（例如，NKF-K / DOQI，KDIGO 和 ERA-EDTA 的欧洲肾脏最佳实践指南）。
介绍了慢性动脉高血压，贫血，铁管理，血脂异常，高血糖以及骨和矿物质代谢紊乱（包括 ESRD 中的高磷血症和继发性甲状旁腺功能亢进症）的常用药物治疗策略。此外，读者还将了解到，ESRD 患者不遵守口服药物治疗可能会导致透析人群的发病率和死亡率显着增加。
ESRD 的药物治疗的改善可能至少部分被透析人群的年龄和合并疾病的不断增加所抵消。 ESRD 患者的个体化和定制化药物治疗仍然是未来的挑战。
