Nephrology Section, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium.
Department of Nephrology-Nutrition-Dialysis, Centre Hospitalier Lyon Sud, Carmen-CENS, Université Claude Bernard Lyon 1, Lyon, France; Investigation Network Initiative Cardiovascular and Renal Clinical Trialists (INI-CRCT), French Clinical Research Infrastructure Network (F-CRIN), Nancy, France.
Lancet Diabetes Endocrinol. 2016 Apr;4(4):360-73. doi: 10.1016/S2213-8587(16)00033-4. Epub 2016 Mar 3.
The clinical picture of the uraemic syndrome is a complex amalgam of accelerated ageing and organ dysfunction, which progress in parallel to chronic kidney disease. The uraemic syndrome is associated with cardiovascular disease, metabolic bone disease, inflammation, protein energy wasting, intestinal dysbiosis, anaemia, and neurological and endocrine dysfunction. In this Review, we summarise specific, modern management options for the uraemic syndrome in chronic kidney disease. Although large randomised controlled trials are scarce, based on data from randomised controlled trials and observational studies, as well as pathophysiological reasoning, a therapeutic algorithm can be developed for this complex and multifactorial condition, with interventions targeting several modifiable factors simultaneously.
尿毒症综合征的临床表现是加速衰老和器官功能障碍的复杂混合，与慢性肾脏病平行进展。尿毒症综合征与心血管疾病、代谢性骨病、炎症、蛋白质能量消耗、肠道菌群失调、贫血以及神经和内分泌功能障碍有关。在这篇综述中，我们总结了慢性肾脏病中尿毒症综合征的具体现代治疗选择。尽管大型随机对照试验稀缺，但基于随机对照试验和观察性研究的数据以及病理生理学推理，可以为这种复杂的多因素疾病制定治疗算法，同时针对多个可改变的因素进行干预。
