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灵便期中分析:一项针对希腊慢性肾脏病(CKD)且估算肾小球滤过率(eGFR)降低的门诊患者的多中心前瞻性观察研究,以评估治疗算法、疾病管理及生活质量。

Spirit Interim Analysis: A Multicenter Prospective Observational Study of Outpatients with CKD and Decreased eGFR to Assess Therapeutic Algorithms, Disease Management and Quality of Life in Greece.

作者信息

Petras Dimitrios, Marinaki Smaragdi, Panagoutsos Stylianos, Stefanidis Ioannis, Stylianou Kostantinos, Ntounousi Evangelia, Lionaki Sofia, Tzanakis Ioannis, Griveas Ioannis, Xidakis Dimitrios, Theodoropoulou Eleni, Gourlis Dimitris, Andreadellis Argyris, Goumenos Dimitrios, Liakopoulos Vassilios

机构信息

Nephrology Department, Hippokration General Hospital, 11527 Athens, Greece.

Department of Nephrology, Laiko General Hospital, National and Kapodistrian University School of Medicine, 11527 Athens, Greece.

出版信息

J Clin Med. 2025 Mar 18;14(6):2079. doi: 10.3390/jcm14062079.

Abstract

Chronic Kidney Disease (CKD) affects 8-16% of the population worldwide and is characterized by an estimated Glomerular Filtration Rate (eGFR) of less than 60 mL/min/1.73 m for more than 3 months. The main purpose of the study is to record the treatment algorithms and disease management of patients presenting for the first time to hospital-based nephrologists with a reduced eGFR and CKD diagnosis, under real-world clinical practice in Greece. This is the 6-month interim analysis of an ongoing, multicenter, observational, prospective, national study, which included 178 patients, with an eGFR between <60 and 15 mL/min/1.73 m, presenting for the first time to nephrologists at 15 public hospital units. The median age of the patients was 71 years old, with 39.6% of them categorized as CKD stage G3b. Of these patients, 71.6% and 33.7% suffered from arterial hypertension and type 2 diabetes mellitus, respectively; 78.7% of patients received antihypertensive and 38.5% antidiabetic medications. Calcium channel blocker usage increased with disease progression (from 52.2% at G3a, to 67.9% and 67.6% at G3b and G4, respectively), while that of angiotensin II receptor antagonists decreased (from 78.3% at G3a, to 41.5% and 17.6% at G3b and G4, respectively). A decrease in metformin usage and an increase in Dipeptidyl peptidase-4 inhibitor (DPP4i) usage was also observed upon disease progression. Furthermore, 18.5%, 32.0% and 7.7% of patients received Sodium-glucose cotransporter-2 inhibitors (SGLT2i) at the G3a, G3b and G4 stages, respectively. : The interim analysis results contributed to the collection of real-world data for the therapeutic patterns and the management of CKD in Greece.

摘要

慢性肾脏病(CKD)影响着全球8%至16%的人口,其特征是估计肾小球滤过率(eGFR)低于60 mL/分钟/1.73平方米且持续超过3个月。该研究的主要目的是在希腊的实际临床实践中,记录首次因eGFR降低和CKD诊断而就诊于医院肾病科医生的患者的治疗算法和疾病管理情况。这是一项正在进行的多中心、观察性、前瞻性全国性研究的6个月中期分析,该研究纳入了178例患者,其eGFR在<60至15 mL/分钟/1.73平方米之间,首次在15个公立医院科室就诊于肾病科医生。患者的中位年龄为71岁,其中39.6%被归类为CKD G3b期。在这些患者中,分别有71.6%和33.7%患有动脉高血压和2型糖尿病;78.7%的患者接受抗高血压药物治疗,38.5%的患者接受抗糖尿病药物治疗。钙通道阻滞剂的使用随疾病进展而增加(从G3a期的52.2%,分别增至G3b期和G4期的67.9%和67.6%),而血管紧张素II受体拮抗剂的使用则减少(从G3a期的78.3%,分别降至G3b期和G4期的41.5%和17.6%)。随着疾病进展,还观察到二甲双胍的使用减少,二肽基肽酶-4抑制剂(DPP4i)的使用增加。此外,分别有18.5%、32.0%和7.7%的患者在G3a期、G3b期和G4期接受钠-葡萄糖协同转运蛋白-2抑制剂(SGLT2i)治疗。中期分析结果有助于收集希腊CKD治疗模式和管理的真实世界数据。

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