Ketteler Markus
Allg. Innere Medizin u. Nephrologie, Robert-Bosch-Krankenhaus, Stuttgart, Deutschland.
Dtsch Med Wochenschr. 2024 Aug;149(17):1039-1044. doi: 10.1055/a-2145-7564. Epub 2024 Aug 15.
The KDIGO Update 2024 was supplemented by new "Clinical Practice Points", which were derived from the current evidence but are not necessarily comprehensively proven by prospective controlled studies. The most significant change in the Update 2024 for Lupus nephritis concerns the recommendations for induction therapy for lupus nephritis classes III and IV. The basis is still high-dose glucocorticoid treatment and the use of hydroxychloroquine. The 2 new developments in the 2024 Update concerning ANCA-associated nephritis are based on the studies on the use of the C5a receptor inhibitor Avacopan and the increasing data on induction protocols with reduced glucocorticoid dosage. Due to the inconsistency and variability of the conditions under which blood pressure measurements are carried out in practice, an international consensus statement was issued which defines 4 steps to achieve sufficient validity of the measurement results. CKD-MBD Controversies Conference 2023: The update for CKD-MBD, which was discussed in the Controversies Conference 2023, is in progress and has not been released yet. However, there were no serious contradictions between the 2023 data and the 2017 guidelines - the risk assessment regarding calcium-containing phosphate binders may have been put into perspective.
《KDIGO 2024更新版》新增了“临床实践要点”,这些要点源自当前证据,但不一定经过前瞻性对照研究的全面验证。《2024更新版》中狼疮性肾炎最显著的变化涉及狼疮性肾炎III级和IV级诱导治疗的建议。基础仍然是大剂量糖皮质激素治疗和使用羟氯喹。《2024更新版》中关于抗中性粒细胞胞浆抗体相关性肾炎的两个新进展基于使用C5a受体抑制剂阿伐库潘的研究以及糖皮质激素剂量降低的诱导方案方面越来越多的数据。由于实际测量血压的条件不一致且存在变异性,发布了一份国际共识声明,定义了实现测量结果充分有效性的4个步骤。2023年CKD-MBD争议会议:在2023年争议会议上讨论的CKD-MBD更新正在进行中,尚未发布。然而,2023年的数据与2017年指南之间没有严重矛盾——关于含钙磷结合剂的风险评估可能已得到正确看待。