酸碱平衡与肾脏疾病进展。
Acid Base Balance and Progression of Kidney Disease.
机构信息
Department of Medicine, Nephrology Division, Albert Einstein College of Medicine, Bronx, NY; Department of Medicine, Nephrology Division, University of Rochester School of Medicine and Dentistry, Rochester, NY.
Department of Medicine, Nephrology Division, University of Rochester School of Medicine and Dentistry, Rochester, NY.
出版信息
Semin Nephrol. 2019 Jul;39(4):406-417. doi: 10.1016/j.semnephrol.2019.04.009.
Abstract
A large body of work in animals and human beings supports the hypothesis that metabolic acidosis has a deleterious effect on the progression of kidney disease. Alkali therapy, whether pharmacologically or through dietary intervention, appears to slow CKD progression, but an appropriately powered randomized controlled trial with a low risk of bias is required to reach a more definitive conclusion. Recent work on urinary ammonium excretion has shown that the development of prognostic tools related to acidosis is not straightforward, and that application of urine markers such as ammonium may require more nuance than would be predicted based on our understanding of the pathophysiology.
摘要
大量的动物和人类研究支持这样一种假设，即代谢性酸中毒对肾脏疾病的进展有不良影响。碱化治疗，无论是通过药理学还是通过饮食干预，似乎都能减缓 CKD 的进展，但需要进行一项风险低、有足够效力的随机对照试验，才能得出更明确的结论。最近关于尿铵排泄的研究表明，开发与酸中毒相关的预后工具并不简单，应用尿标志物（如铵）可能需要比我们基于病理生理学理解所预测的更细微的调整。
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