慢性肾脏病的筛查:观念转变与新进展。

Screening for chronic kidney disease: change of perspective and novel developments.

机构信息

Department of Nephrology.

Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, The Netherlands.

出版信息

Curr Opin Nephrol Hypertens. 2024 Nov 1;33(6):583-592. doi: 10.1097/MNH.0000000000001016. Epub 2024 Aug 13.

Abstract

PURPOSE OF REVIEW

Chronic kidney disease (CKD) is a serious health issue because of its rising global prevalence and its complications, such as kidney failure and cardiovascular disease (CVD). CKD is mainly diagnosed late or undiagnosed, delaying or missing the initiation of preventive interventions. Screening can prevent or delay progressive kidney function decline and CVD. This article reviews diagnostic tests and risk prediction developments for patients with CKD, highlights key evidence for targeted screening, and provides new insights into population-wide screening.

RECENT FINDINGS

Large cohort studies and clinical trial data established the strong association of albuminuria with CKD outcomes, supporting the role of albuminuria as target of CKD screening and treatment. Significant advances in both risk prediction of CKD and CVD in CKD patients and treatment options provided new evidence for the relevance and implications of CKD screening. Guidelines recommend targeted screening in high-risk patients, but evidence suggests limited adherence to guideline recommendations. More recently, population-wide screening has been investigated as another approach, showing potential effectiveness and cost-effectiveness.

SUMMARY

There is increasing evidence for the methods, implications, and effectiveness of CKD screening. Implementing and optimizing screening strategies requires enhanced awareness and understanding of the possibilities for CKD screening within different healthcare systems.

摘要

目的综述

慢性肾脏病(CKD)是一个严重的健康问题,因为其在全球的发病率不断上升,以及它所引发的并发症,如肾衰竭和心血管疾病(CVD)。CKD 主要是因为诊断延迟或漏诊,从而延误或错失了预防干预的时机。筛查可以预防或延缓肾功能的进行性下降和 CVD。本文综述了 CKD 患者的诊断检测和风险预测的进展,强调了针对特定人群筛查的关键证据,并为人群筛查提供了新的见解。

最新发现

大型队列研究和临床试验数据证实了白蛋白尿与 CKD 结局之间的强相关性,支持将白蛋白尿作为 CKD 筛查和治疗的靶点。在 CKD 患者的 CKD 和 CVD 风险预测以及治疗方案方面的显著进展,为 CKD 筛查的相关性和意义提供了新的证据。指南建议对高危患者进行有针对性的筛查,但有证据表明,对指南建议的遵循程度有限。最近,人群筛查也被作为另一种方法进行了研究,显示出潜在的有效性和成本效益。

总结

目前有越来越多的证据表明 CKD 筛查的方法、意义和效果。实施和优化筛查策略需要提高对不同医疗保健系统中 CKD 筛查可能性的认识和理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17d6/11426989/57b93c852321/conhy-33-583-g001.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索