본문 바로가기
KERD
논문KCI 등재

만성 콩팥병 단계에 따른 치료의 최신 경향

Recent therapeutic strategies based on the stage of chronic kidney disease

2

조회

0

다운로드

6

인용

0

참고문헌

키워드

주제분류내과학

초록

Chronic kidney disease (CKD) is a major public health problem. It is estimated that 400-600 million adults worldwide have CKD. Furthermore, more than 5% of the adult population has some form of kidney damage. CKD is not an isolated disease, but is strongly linked to other health problems, such as diabetes and cardiovascular diseases (CVD), with high blood pressure as the main indicating risk factor. For example, every year millions die prematurely of CKD-linked CVD alone. However, adverse outcomes of CKD can be prevented through early detection and treatment. Earlier stages of the disease can be detected through routine laboratory measurements. Therefore, a clinical action plan should be developed for each patient, based on the stage of disease. The basic principle of treatment for CKD is to prevent the further deterioration of renal function and to minimize complications, including cardiovascular events. For this purpose, treatment should include specific therapy based on the underlying disease; an evaluation of comorbid conditions; a method of slowing the loss of renal function; the prevention and treatment of CVD as well as complications associated with decreased renal function; and replacement treatment for renal function, using dialysis and transplantation, if signs and symptoms of uremia are present.

Abstract

Chronic kidney disease (CKD) is a major public health problem. It is estimated that 400-600 million adults worldwide have CKD. Furthermore, more than 5% of the adult population has some form of kidney damage. CKD is not an isolated disease, but is strongly linked to other health problems, such as diabetes and cardiovascular diseases (CVD), with high blood pressure as the main indicating risk factor. For example, every year millions die prematurely of CKD-linked CVD alone. However, adverse outcomes of CKD can be prevented through early detection and treatment. Earlier stages of the disease can be detected through routine laboratory measurements. Therefore, a clinical action plan should be developed for each patient, based on the stage of disease. The basic principle of treatment for CKD is to prevent the further deterioration of renal function and to minimize complications, including cardiovascular events. For this purpose, treatment should include specific therapy based on the underlying disease; an evaluation of comorbid conditions; a method of slowing the loss of renal function; the prevention and treatment of CVD as well as complications associated with decreased renal function; and replacement treatment for renal function, using dialysis and transplantation, if signs and symptoms of uremia are present.

참고문헌 (22)

  1. National Kidney Foundation, "K", DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification, 2002, pp.39(1), S1~S266
  2. 김성권, "The Prevalence of Chronic Kidney Disease (CKD) and the Associated Factors to CKD in Urban Korea: A Population-based Cross-sectional Epidemiologic Study", Journal of Korean Medical Science, 24, pp.11~21 (2009), 대한의학회
  3. Perazella MA, "Current status of gadolinium toxicity in patients with kidney disease", Clin J Am Soc Nephrol, 4, pp.461~469 (2009)
  4. Bots ML, "Common carotid intima-media thickness and risk of stroke and myocardial infarction", Circulation, 96, pp.1432~1437 (1997)
  5. Hayashi K, "Ca2+ channel subtypes and pharmacology in the kidney", Circ Res, 100, pp.342~353 (2007)
  6. Mann JF, "Renal outcomes with telmisartan, ramipril, or both, in people at high vascular risk (the ONTARGET study): a multicentre, randomised, double-blind, controlled trial", Lancet, 372, pp.547~553 (2008)
  7. Parving HH, "Aliskiren combined with losartan in type 2 diabetes and nephropathy", N Engl J Med, 358, pp.2433~2446 (2008)
  8. Sica DA, "The risks and benefits of therapy with aldosterone receptor antagonist therapy", Curr Drug Saf, 2, pp.71~77 (2007)
  9. Colhoun HM, "Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial", Lancet, 364, pp.685~696 (2004)
  10. Baigent C, "Study of Heart and Renal Protection (SHARP)", Kidney Int Suppl, pp.S207~S210 (2003)
  11. Levey AS, "Controlling the epidemic of cardiovascular disease in chronic renal disease: what do we know? what do we need to learn? where do we go from here?", Am J Kidney Dis, 32, pp.853~906 (1998)
  12. Expert Panel on Detection Evaluation and Treatment of High Blood Cholesterol in Adults, "Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)", JAMA, 285, pp.2486~2497 (2001)
  13. Lowrie EG, "Death risk in hemodialysis patients: the predictive value of commonly measured variables and an evaluation of death rate differences between facilities", Am J Kidney Dis, 15, pp.458~482 (1990)
  14. Lowrie EG, "Commonly measured laboratory variables in hemodialysis patients: relationships among them and to death risk", Semin Nephrol, 12, pp.276~283 (1992)
  15. Iseki K, "Hypocholesterolemia is a significant predictor of death in a cohort of chronic hemodialysis patients", Kidney Int, 61, pp.1887~1893 (2002)
  16. Wanner C, "Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis", N Engl J Med, 353, pp.238~248 (2005)
  17. Fellström BC, "AURORA Study Group. Rosuvastatin and cardiovascular events in patients undergoing hemodialysis", N Engl J Med, 360, pp.1395~1407 (2009)
  18. National Kidney Foundation, "K", DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease, 2003, pp.42(3), S1~S201
  19. Cannella G, "Therapy of secondary hyperparathyroidism to date: vitamin D analogs, calcimimetics or both?", J Nephrol, 19, pp.399~402 (2006)
  20. Kwen JH, "The study of anemia in stable chronic kidney disease patients not receiving dialysis treatment", Korean J Nephrol, 22, pp.63~72 (2003)
  21. Levin A, "Identification of patients and risk factors in chronic kidney disease: evaluating risk factors and therapeutic strategies", Nephrol Dial Transplant, 16(7), pp.57~60 (2001)
  22. "K/DOQI clinical practice guidelines and clinical practice recommendations for anemia in chronic kidney disease: 2007 update of hemoglobin target"[URL]

관련 논문AI추천

이 간행물의 다른 논문 (11건)