Schaeffner Elke
Dtsch Med Wochenschr. 2025 Jan;150(3):77-82. doi: 10.1055/a-2265-9422. Epub 2025 Jan 14.
The article is based, among other things, on the updated KDIGO guideline for the evaluation and management of chronic kidney disease, which was published in Kidney International in March 2024. Chronic kidney disease is one of the most common chronic diseases, with a prevalence of around 10%, not least due to demographic ageing. The incidence of chronic kidney disease is approximately twice that of diabetes and approximately 20 times higher than that of cancer. Chronic kidney disease is classified using glomerular filtration rate and albuminuria. The definition of CKD may also include markers other than GFR and ACR. Patients with diabetes or hypertension should have GFR and ACR tested regularly. The individual risk of kidney failure requiring dialysis can be determined using a prediction equation. A better understanding of age- and gender-specific differences means that personalized therapy approaches are becoming increasingly important. Clinicians should be aware of the limitations of the endogenous biomarkers creatinine and cystatin C for determining GFR. For Germany, the equations of the European Kidney Function Consortium (EKFC) are recommended for estimating GFR.
本文尤其基于2024年3月发表于《国际肾脏病杂志》的更新版KDIGO慢性肾脏病评估与管理指南。慢性肾脏病是最常见的慢性病之一,患病率约为10%,这在很大程度上归因于人口老龄化。慢性肾脏病的发病率约为糖尿病的两倍,约为癌症的20倍。慢性肾脏病根据肾小球滤过率和蛋白尿进行分类。慢性肾脏病的定义可能还包括肾小球滤过率和尿白蛋白肌酐比值以外的标志物。糖尿病或高血压患者应定期检测肾小球滤过率和尿白蛋白肌酐比值。使用预测方程可以确定需要透析的个体肾衰竭风险。对年龄和性别特异性差异的更好理解意味着个性化治疗方法变得越来越重要。临床医生应意识到内源性生物标志物肌酐和胱抑素C在测定肾小球滤过率方面的局限性。对于德国,推荐使用欧洲肾功能联盟(EKFC)的方程来估算肾小球滤过率。