Renal fibrosis is the common pathological basis for the progressive development of chronic kidney disease(CKD)caused by various etiologies.It is characterized by the persistent deposition of extracellular matrix,leadi...Renal fibrosis is the common pathological basis for the progressive development of chronic kidney disease(CKD)caused by various etiologies.It is characterized by the persistent deposition of extracellular matrix,leading to renal tissue damage and impaired renal function,and ultimately progressing to kidney failure.Current clinical treatments for CKD mainly focus on managing the primary diseases,with no specific drugs targeting renal fibrosis.The pathogenesis of renal fibrosis is complex,and there are currently no drugs available to reverse it.A comprehensive overview of the pathogenesis of renal fibrosis,alongside a summary of current anti-fibrotic therapies,including some that are already used clinically to slow renal function progression,new drugs in clinical trials,and emerging targeted therapies,could provide new theoretical foundations and perspectives for the treatment of renal fibrosis.展开更多
目的:维持性血液透析(maintenance hemodialysis,MHD)是终末期肾病患者重要的替代治疗方法之一。丙型肝炎病毒(hepatitis C virus,HCV)感染是全球严重的公共卫生问题,MHD患者合并HCV感染的比例及不良预后风险高于一般人群,积极的抗病毒...目的:维持性血液透析(maintenance hemodialysis,MHD)是终末期肾病患者重要的替代治疗方法之一。丙型肝炎病毒(hepatitis C virus,HCV)感染是全球严重的公共卫生问题,MHD患者合并HCV感染的比例及不良预后风险高于一般人群,积极的抗病毒治疗并预防再次感染事件的发生是肾病内科与感染病科医师联合治疗理念的体现。为HCV感染治愈患者设置血液透析缓冲区是一个有效的预防措施,但其有效性及安全性仍需进一步探究。本研究旨在探索MHD合并HCV感染患者在血液透析过程中的抗病毒治疗方案及预后情况。方法:回顾性分析中南大学湘雅医院血液净化中心HCV区10例长期血液透析终末期肾病患者的病历资料。完成规范的抗病毒药物治疗方案12周或24周后监测血清HCV-RNA为阴性,视为达到HCV治愈标准。湘雅医院肾病内科于2017年4月在血液净化中心设置缓冲区,安排HCV感染已治愈的患者由HCV区转入缓冲区继续透析,转区后监测这类患者血清HCV-RNA、抗HCV抗体水平以及临床生化指标,并随访观察HCV治愈后再次感染的情况。结果:10例HCV感染患者经抗病毒治疗后最终均治愈,治疗前后临床生化指标未见显著变化,转区后经27.5(17.5,39.0)个月随访,患者HCV-RNA持续阴性,抗HCV抗体持续阳性。结论:采用直接抗病毒治疗MHD合并HCV感染患者安全、有效,积极的抗病毒治疗及HCV转阴患者缓冲区透析是HCV患者在MHD期间新型有效的治疗模式。展开更多
基金supported by the National Natural Science Foundation(82173877 and 82073918)the Natural Science Foundation of Hunan Province(2024JJ5571)the Frontier Cross Project of Central South University(2023QYJC031),China.
文摘Renal fibrosis is the common pathological basis for the progressive development of chronic kidney disease(CKD)caused by various etiologies.It is characterized by the persistent deposition of extracellular matrix,leading to renal tissue damage and impaired renal function,and ultimately progressing to kidney failure.Current clinical treatments for CKD mainly focus on managing the primary diseases,with no specific drugs targeting renal fibrosis.The pathogenesis of renal fibrosis is complex,and there are currently no drugs available to reverse it.A comprehensive overview of the pathogenesis of renal fibrosis,alongside a summary of current anti-fibrotic therapies,including some that are already used clinically to slow renal function progression,new drugs in clinical trials,and emerging targeted therapies,could provide new theoretical foundations and perspectives for the treatment of renal fibrosis.
文摘目的:维持性血液透析(maintenance hemodialysis,MHD)是终末期肾病患者重要的替代治疗方法之一。丙型肝炎病毒(hepatitis C virus,HCV)感染是全球严重的公共卫生问题,MHD患者合并HCV感染的比例及不良预后风险高于一般人群,积极的抗病毒治疗并预防再次感染事件的发生是肾病内科与感染病科医师联合治疗理念的体现。为HCV感染治愈患者设置血液透析缓冲区是一个有效的预防措施,但其有效性及安全性仍需进一步探究。本研究旨在探索MHD合并HCV感染患者在血液透析过程中的抗病毒治疗方案及预后情况。方法:回顾性分析中南大学湘雅医院血液净化中心HCV区10例长期血液透析终末期肾病患者的病历资料。完成规范的抗病毒药物治疗方案12周或24周后监测血清HCV-RNA为阴性,视为达到HCV治愈标准。湘雅医院肾病内科于2017年4月在血液净化中心设置缓冲区,安排HCV感染已治愈的患者由HCV区转入缓冲区继续透析,转区后监测这类患者血清HCV-RNA、抗HCV抗体水平以及临床生化指标,并随访观察HCV治愈后再次感染的情况。结果:10例HCV感染患者经抗病毒治疗后最终均治愈,治疗前后临床生化指标未见显著变化,转区后经27.5(17.5,39.0)个月随访,患者HCV-RNA持续阴性,抗HCV抗体持续阳性。结论:采用直接抗病毒治疗MHD合并HCV感染患者安全、有效,积极的抗病毒治疗及HCV转阴患者缓冲区透析是HCV患者在MHD期间新型有效的治疗模式。
