慢性腎臟病英文

演講人：日期：慢性腎臟病英文OverviewofChronicKidneyDiseaseExplorationofpathologicalandphysiologicalmechanismsClinicalpresentationsandmanagementofapplications目錄TreatmentplanselectionandimplementationpointsPrognosticassessmentandmeasurestoimprovequalityoflife目錄01OverviewofChronicKidneyDiseaseDefinitionChronickidneydisease(CKD)referstovariousreasonsthatcausechronickidneystructureandfunctionalimprovement(withahistoryofkidneydamagegreaterthan3months)ItincludespathologicaldamagewithnormalorabnormalrenalGFR,abnormalitiesinbloodorurinecomponents,andabnormalitiesinimagingexaminations,orunexplainedGFRdecline(<60ml/min·1.73m)formorethan3monthsClassificationCKDcanbedividedinto5stagesbasedonGFREarlydetectionandinterventioncansignificantlyreducecomplicationsandimprovesurvivalratesforCKDpatientsDefinitionandclassificationThediseasesthatcausechronickidneydiseasesincludevariableprimaryandsecondaryglomerulonephritis,renaltubularinjury,andrenalvasculardiseasesCausesRiskfactorsfortheonsetofCKDincludehypertension,diabetes,obesity,smoking,familyhistoryofkidneydisease,andlongtermuseofcentralmedicinethatmaydamagethekidneysRiskfactorsCausesandriskfactorsofonsetClinicalpresentationsanddiagnosticcriteriaSymptomsofCKDmayincludefatigue,nasea,invoicing,lossofappearance,itting,andswitchingAsthediseaseprogresses,patientsmayexperiencemoreseveresymptomssuchasanemia,bonepain,andshortnessofbreathClinicalpresentationsThediagnosisofCKDisbasedonthepresenceofkidneydamageformorethan3months,asevidencedbystructuralorfunctionalabnormalitiesofthekidneys,withorwithoutreducedGFRAdditionaldiagnosticcriteriaincludeabnormalitiesinbloodorurinetestsandimagingstudiesDiagnosticcriteriaCKDisaglobalpublichealthproblem,affectingmillionsofpeopleworldwideTheincidenceandvalidityofCKDvarysignificantlyacrossdifferentregionsandpopulationsGlobalepidemiologicalstatusInChina,thepresenceofCKDisalsohigh,particularlyinolderadultsandindividualswithchronicdiseasessuchashypertensionanddiabetesEarlydetectionandtreatmentofCKDarecriticaltoreducingitsburdenonindividualsandsocietyDomesticempiricalstatusGlobalandDomesticEpitopicStatus02ExplorationofpathologicalandphysiologicalmechanismsProgressivelossofNephronsNephronsarethefunctionalunitsofthekidney,andtheirprogressivelossleadstoadeclineinrenalfunctionGlomerularfiltrationrate(GFR)decreaseGFRisameasureofkidneyfunction,andareductioninGFRindicateskidneydamageTubulardysfunctionDamagetothenewtubescanleadtoelectrolyteimbalances,acidbaseddisorders,andotherapplicationsRenalstructureandfunctiondamageprocessInflammationandkidneydamage01Chronicinflationisakeyfactorintheprocessofkidneydisease,leadingtofurtherdamageandscalingCytokinesandchemotherapy02TheseinflammatorymediatorsplayacriticalroleinrecruitingimmunecellstothekidneyandinitiatingtheinflammatoryresponseMacrophagesandT-cells03TheseimmunecellsareactivatedinresponsetokidneydamageandcontributiontotheinflammatoryprocessTheroleofinflationresponseinCKDOxidativestressAnimbalancebetweenoxidesandantibioticsleadstooxidativestress,whichcandamagekidneycellsandcontributetotheprogressionofCKDFibrosisExcesspositionofextracellarmatrixproteinsleadstofibrosis,whichisahallmarkofCKDprogressTransforminggrowthfactorbeta(TGFbeta)ThiscytokineplayakeyroleinthedevelopmentoffibrosisandisregulatedinCKDAnalysisofoxidativestressandfiberprocessGeneticpreparationCertaingeneticmutationscanincreaseanindividual'sriskofdevelopingCKDFamilyclusteringCKDofclusterswithinfamilies,suggestingageneticcomponenttothediseaseGenomewideassociationstudies(GWAS)GWAShasidentifiedmultiplegeneticlociassociatedwithanincreasingriskofCKD,providinginsightsintothegeneticarchitectureofthediseaseTheimpactofgeneticfactorsonCKD03ClinicalpresentationsandmanagementofapplicationsEarlyscreeningforchronickidneydisease(CKD)involvesidentifyingindividualsatriskthroughroutinebloodandurinetestsEvaluationmethodsincludeestimatingglobalfiltrationrate(eGFR)andalbumintocreativityratio(ACR)toassesskidneyfunctionanddetectalbumin,respectivelyRegularmonitoringofkidneyfunctionandalbuminiscriticalforearlydetectionandmanagementofCKDDiscussiononEarlyScreeningandEvaluationMethodsCorrectivemeasuresforwaterelectronbalanceinCKDpatientsfocusonrestoringnormalfluidandelectrolytelevelsThismayinvolvedietarymodifications,suchasrestrictingsaltandpotassiumintake,andpreallocatingappropriatemedicinesInmultiplecases,diagnosismaybenecessarytocorrectelectrolyteimbalancesandremovewasteproductsfromthebloodCorrectivemeasuresforwaterelectrolysisimbalancedisorder

PreventionstrategiesforcardiovascularcomplexesPreventingcardiovascularcomplicationsinCKDpatientsiscritical,astheyareatincreasedriskforheartdiseaseStrategiesincludemanagingtension,controllingbloodsugarlevels,andtreatingdyslipidemiaLifestylemodifications,suchassmokingtreatment,regularexercise,andahealthydiet,arealsorecommendedInmultiplecases,surgicalinterventionsmaybenecessarytotreatbonefracturesordeformitiescausedbyretinalastrologyAnemiaisacommonapplicationofCKDandcanbetreatedwitherythropoiesisstimulatingagents(ESA)orirontherapyAbnormalbonemetabolism,knownasretinalastrology,canbemanagedwithcalciumandphosphatebinders,vitaminDanalyses,andothermediaTreatmentofotherissuessuchasanimiaandabnormalbonemetabolism04TreatmentplanselectionandimplementationpointsDrugtherapyprinciplesTheselectionofdrugsshouldaimtocontrolbloodpressure,reduceproteinuria,correctanemia,andrelatedsymptomswhileminimizingsideeffectsonkidneyfunctionSpecificdrugintroductionCommonlyuseddrugsincludeantihypertensivessuchasACEinhibitorsandARBs,erythropoietinforammoniacorrection,andphasebindersforhyperphasemiacontrolPrinciplesofDrugTherapyandSpecificDrugIntroductionRegularnutritionalassessmentsshouldbeconductedtoidentifynutritionaldeficienciesanddevelopappropriatedietaryplansNutritionalassessmentsProteinintakeshouldbecontrolledtoavoidexcessiveprocessburnsonthekidneys,whileensuringequalnutritionforthebodyProteinintakeElectrolytelevelssuchaspotassium,sodium,andphosphorusshouldbemonitoredandmaintainedwithinnormalrangestopreventcomplicationsElectrolytebalanceDeploymentofnutritionalsupporttreatmentstrategiesAnalysistimingAnalysisshouldbeinitiatedwhenkidneyfunctiondependstoacertainextent,typicallywhenestimatedglucosefiltrationrate(eGFR)fallsbelowacertainthreshold0102TranslationconsiderationsKidneytransplantationmaybeconsideredforsuitablepatientswithendstagerenaldisease(ESRD)asitoffersbettersurvivalratesandqualityoflifecomparedtodiabetesTimingofalternativetreatment(diagnosis,translation)PsychologicalsupportChronickidneydiseasecanhaveasignificantimpactonpatients'mentalhealth,andpsychologicalinterventionssuchasissuingandsupportgroupscanhelppatientsscopewiththediseaseRehabilitationcounselingRehabilitationcounselorscanassistpatientsindevelopingself-managementskills,improvingqualityoflife,andreturningtonormalactivitiesasmanyaspossibleTheycanalsoprovideguidanceonemploymentandfinancialissuesrelatedtotheissuePatientpsychologicalinterventionandrehabilitationcounseling05Prognosticassessmentandmeasurestoimprovequalityoflife010203RenalfunctionmarkersEstimationofglobalfiltrationrate(eGFR)andestimationarekeyindicatorsforassessingrenalfunctionandpredictingpredictionsCardiovascularriskassessmentEvaluationofbloodpressure,lipidprofile,andotherCardiovascularriskfactorsarecriticalforCKDpatientsduetothehighincidenceofCardiovascularcomplicationsNutritionalstatusandanimiaassessmentRegularmonitoringofnutritionalmarkersandgloballevelshelpstoidentifyandmanagenutritionaldeficienciesandanimia,whicharecommoninCKDpatientsDiscussionondiagnosticevaluationindicatorsandmethodsOptimalbloodpressurecontrolStrictbloodpressurecontrolcaneffectivelyslowdowntheprogressofCKDandreducetheriskofcardiovasculareventsManagementofhyperglycemiaanddyslipidemiaControllingbloodsugarandlivelevelsisessentialfordelayingtheprogressionofCKDandpreventingassociatedcomplicationsRenalprotectivedrugtherapyTheuseofrenalprotectivedrugssuchasangiotensinconvertingenzymeinhibitors(ACEIs)