{"id":45903,"date":"2025-01-04T05:10:45","date_gmt":"2025-01-04T05:10:45","guid":{"rendered":"https:\/\/zydq.1006ss.com\/?p=45903"},"modified":"2025-01-04T05:10:45","modified_gmt":"2025-01-04T05:10:45","slug":"2024-kdigo-ckd%e7%ae%a1%e7%90%86%e4%b8%8e%e8%af%84%e4%bc%b0%e6%8c%87%e5%8d%97%e6%9b%b4%e6%96%b0%e5%ae%8c%e6%95%b4%e7%89%88","status":"publish","type":"post","link":"http:\/\/zydq.1006ss.com\/?p=45903","title":{"rendered":"2024 KDIGO CKD\u7ba1\u7406\u4e0e\u8bc4\u4f30\u6307\u5357\u66f4\u65b0(\u5b8c\u6574\u7248)"},"content":{"rendered":"<p>                                        2024 KDIGO CKD\u7ba1\u7406\u4e0e\u8bc4\u4f30\u6307\u5357\u66f4\u65b0\u9884\u793a\u7740\u80be\u810f\u75c5\u60a3\u8005\u7ba1\u7406\u7684\u65b0\u65f6\u4ee3\u5230\u6765\u30022012\u5e74\u6307\u5357\u5927\u90e8\u5206\u5185\u5bb9\u5747\u4f9d\u636e\u6700\u65b0\u8bc1\u636e\u548c\u5b9e\u8df5\u66f4\u65b0\uff0c\u4ec5\u4fdd\u75596\u98792012\u5e74\u6307\u5357\u63a8\u8350\/\u5efa\u8bae\u3002\u65b0\u7248\u6307\u5357\u6982\u8ff0\u5982\u4e0b\u3002<\/p>\n<p>\u7b2c1\u7ae0\uff1aCKD\u8bc4\u4f30<\/p>\n<p>1.1 CKD\u8bc6\u522b\u4e0e\u8bc4\u4f30<\/p>\n<p>1.1.1 CKD \u8bc6\u522b<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.1.1.1 \u901a\u8fc7\u68c0\u6d4b\u5c3f\u767d\u86cb\u767d\u548c\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\uff08GFR\uff09\u8bc4\u4f30\u6162\u6027\u80be\u810f\uff08CKD\uff09\u5371\u9669\u4eba\u7fa4<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.1.1.2 \u5076\u5c14\u53d1\u73b0\u5c3f\u767d\u86cb\u767d\u4e0e\u808c\u9150\u6bd4\u503c\uff08ACR\uff09\u5347\u9ad8\u3001\u8840\u5c3f\u6216\u4f30\u8ba1GFR\uff08eGFR\uff09&nbsp;\u964d\u4f4e\uff0c\u5e94\u91cd\u590d\u68c0\u67e5\u786e\u8ba4CKD\u662f\u5426\u5b58\u5728<\/p>\n<p>1.1.2 CKD\u5206\u671f\u65b9\u6cd5<\/p>\n<p>1.1.3 \u6162\u6027\u5316\u8bc4\u4f30<\/p>\n<p>\u5b9e\u8df5\u89811.1.3.1\uff1a\u6162\u6027\u5316\uff08\u6301\u7eed\u65f6\u95f4\u81f3\u5c113\u6708\uff09\u53ef\u901a\u8fc7\u4ee5\u4e0b\u65b9\u5f0f\u786e\u5b9a\uff1a i\u56de\u987e\u65e2\u5f80GFR\u68c0\u6d4b\/\u4f30\u8ba1\u60c5\u51b5\uff1b ii\u56de\u987e\u65e2\u5f80\u5c3f\u767d\u86cb\u767d\u6216\u86cb\u767d\u5c3f\u68c0\u6d4b\u53ca\u5c3f\u6db2\u663e\u5fae\u955c\u68c0\u67e5\uff1biii\u5f71\u50cf\u5b66\u68c0\u67e5\u7ed3\u679c\u5982\u80be\u810f\u7f29\u5c0f\u548c\u76ae\u8d28\u539a\u5ea6\u964d\u4f4e\uff1biv\u80be\u810f\u75c5\u7406\u53d1\u73b0\u5982\u7ea4\u7ef4\u5316\u548c\u840e\u7f29\uff1bv\u75c5\u53f2\uff0c\u5c24\u5176\u662f\u5bfc\u81f4\u6216\u4fc3\u8fdbCKD\u53d1\u751f\u7684\u60c5\u51b5\uff1bvi 3\u6708\u5185\u548c\u4e4b\u540e\u91cd\u590d\u68c0\u6d4b\u3002<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.1.3.2\uff1a\u4e0d\u8981\u6839\u636eeGFR\u548cACR\u5355\u4e00\u5f02\u5e38\u5373\u63a8\u5b9a\u4e3a\u6162\u6027\u5316\uff0c\u56e0\u4e3a\u8fd9\u53ef\u80fd\u662f\u8fd1\u671f\u6025\u6027\u80be\u635f\u4f24\uff08AKI\uff09\u4e8b\u4ef6\u6216\u6025\u6027\u80be\u810f\u75c5\uff08AKD\uff09\u7684\u7ed3\u679c<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.1.3.3\uff1a\u82e5\u5176\u4ed6\u4e34\u5e8a\u6307\u6807\u786e\u8ba4CKD\u5b58\u5728\uff0c\u5219\u9996\u6b21\u51fa\u73b0GFR\u4e0b\u964d\u6216ACR\u5347\u9ad8\u5373\u5e94\u542f\u52a8CKD\u6cbb\u7597<\/p>\n<p>1.1.4 \u75c5\u56e0\u8bc4\u4f30<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.1.4.1\uff1a\u901a\u8fc7\u4e34\u5e8a\u80cc\u666f\u3001\u4e2a\u4eba\u548c\u5bb6\u65cf\u53f2\u3001\u793e\u4f1a\u548c\u73af\u5883\u56e0\u7d20\u3001\u836f\u7269\u3001\u4f53\u683c\u68c0\u67e5\u3001\u5b9e\u9a8c\u5ba4\u68c0\u6d4b\u3001\u5f71\u50cf\u5b66\u53ca\u9057\u4f20\u5b66\u548c\u75c5\u7406\u5b66\u8bca\u65ad\u786e\u5b9aCKD\u75c5\u56e0\uff08Figure 8\uff09<\/p>\n<p>Figure 8 | \u6162\u6027\u80be\u810f\u75c5\uff08CKD\uff09\u75c5\u56e0\u8bc4\u4f30\u5b9e\u8df5\u8981\u70b91.1.4.2\uff1a\u4f9d\u636e\u5b9e\u9645\u60c5\u51b5\u786e\u5b9aCKD\u539f\u56e0\uff08Table 6\uff09Table 6 |&nbsp;CKD\u539f\u56e0\u8bc4\u4f30\u68c0\u6d4b\/\u68c0\u67e5\u9009\u62e9\u6307\u5bfcANCA \u6297\u4e2d\u6027\u7c92\u7ec6\u80de\u80de\u6d46\u6297\u4f53\uff1bAPOL1 \u8f7d\u8102\u86cb\u767d1\uff1bCOL4A IV\u578b\u80f6\u539f\u03b1\u94fe\uff1bCT \u8ba1\u7b97\u673a\u65ad\u5c42\u626b\u63cf\uff1bGBM \u80be\u5c0f\u7403\u57fa\u5e95\u819c\uff1bHNF1B \u809d\u7ec6\u80de\u6838\u56e0\u5b501B\uff1bMRI \u78c1\u5171\u632f\u6210\u50cf\uff1bNPHS1 \u5148\u5929\u6027\u80be\u75c5\u7efc\u5408\u5f81\uff1bPKD1 \u591a\u56ca\u80be\u75c5-1\uff1bPKD2 \u591a\u56ca\u80be\u75c5-2\uff1bPLA2R M\u578b\u78f7\u8102\u9176A2\u53d7\u4f53\uff1bUMOD \u5c3f\u8c03\u8282\u7d20<\/p>\n<p>1.2 GFR\u8bc4\u4f30<\/p>\n<p>1.2.1\u80be\u810f\u9664GFR\u5916\u5176\u4ed6\u529f\u80fd<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.2.1.1\uff1a\u8868\u8fbe\u80be\u5c0f\u7403\u6ee4\u8fc7\u7684\u7279\u6307\u80be\u529f\u80fd\uff0c\u5e94\u4f7f\u7528\u672f\u8bed\u201cGFR\u201d\u3002\u800c\u80be\u810f\u5168\u90e8\u529f\u80fd\u5219\u4f7f\u7528\u66f4\u666e\u904d\u672f\u8bed\u201c\u80be\u529f\u80fd\u201d<\/p>\n<p>1.2.2 \u6307\u5bfc\u5185\u79d1\u533b\u751f\u548c\u5176\u4ed6\u533b\u7597\u536b\u751f\u5de5\u4f5c\u8005<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.2.2.1\uff1a\u4f7f\u7528\u8840\u6e05\u808c\u9150\uff08SCr\uff09\u548c\u4f30\u8ba1\u65b9\u7a0b\u521d\u6b65\u8bc4\u4f30GFR\uff08Figure 11\uff09<\/p>\n<p>Figure 11 | \u521d\u6b65\u548c\u652f\u6301\u6027\u68c0\u6d4b\u8bc4\u4f30\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\uff08GFR\uff09\u3002\u4e0a\u56fe\u5c55\u793a\u4e86GFR\u8bc4\u4f30\u65b9\u6cd5\uff0c\u4ee5\u521d\u6b65\u548c\u652f\u6301\u6027\u68c0\u6d4b\u660e\u786e\u771f\u5b9eGFR\u7684\u6700\u7ec8\u8bc4\u4f30\u8def\u5f84\uff0c\u540c\u65f6\u7528\u4e8e\u4e2a\u4f53\u5316\u6cbb\u7597\u51b3\u7b56\u3002\u521d\u6b65\u68c0\u6d4b\u8bc4\u4f30GFR\u57fa\u4e8e\u808c\u9150\u4f30\u8ba1GFR\uff08eGFRcr\uff09\u9002\u7528\u4e8e\u5927\u591a\u6570\u4eba\u7fa4\u2014\u2014\u808c\u9150\u4f9d\u636e\u57fa\u7840\u4ee3\u8c22\u68c0\u6d4b\u3002\u82e5\u9884\u8ba1eGFRcr\u4e0d\u51c6\u786e\uff0c\u6216\u4e34\u5e8a\u51b3\u7b56\u9700\u66f4\u51c6\u786e\u8bc4\u4f30GFR\u5982\u6162\u6027\u80be\u810f\u75c5\u8bca\u65ad\u6216\u5206\u671f\u6216\u7ed9\u836f\u5242\u91cf\uff0c\u5e94\u68c0\u6d4b\u80f1\u6291\u7d20C\uff08\u5c3d\u53ef\u80fd\uff09\uff0c\u5e76\u8bc4\u4f30\u57fa\u4e8e\u808c\u9150\u548c\u80f1\u6291\u7d20C\u7684\u4f30\u8ba1GFR\uff08eGFRcr-cys\uff09\u3002\u82e5eGFRcr-cys\u9884\u8ba1\u4e0d\u51c6\u786e\uff0c\u6216\u4e34\u5e8a\u51b3\u7b56\u9700\u66f4\u51c6\u786e\u8bc4\u4f30GFR\uff0c\u5e94\u4f7f\u7528\u8840\u6d46\u6216\u5c3f\u6db2\u5916\u6e90\u6027\u6ee4\u8fc7\u6807\u5fd7\u7269\u6e05\u9664\u7387\u68c0\u6d4bGFR\u3002*\u5065\u5eb7\u4eba\u7fa4\u7531\u4e8e\u975eGFR\u51b3\u5b9a\u56e0\u7d20\uff08\u5982\u808c\u8089\u91cf\u6216\u808c\u9150\u5206\u6ccc\u53d8\u5316\u6216\u7279\u5b9a\u836f\u7269\u5f15\u8d77\u80be\u5916\u6e05\u9664\uff09\u5bfc\u81f4\u808c\u9150\u751f\u6210\u53d8\u5316\uff0c\u521d\u6b65\u68c0\u6d4b\u53ef\u9700\u4f7f\u7528\u57fa\u4e8e\u80f1\u6291\u7d20C\uff08eGFRcys\u6216eGFRcr-cys\uff09\u8bc4\u4f30GFR\u3002\u2020eGFRcr-cys\u8bef\u5dee\u5305\u62ec\u808c\u8089\u91cf\u6781\u4f4e\u6216\u6781\u9ad8\u708e\u75c7\u72b6\u6001\u3001\u9ad8\u5206\u89e3\u4ee3\u8c22\u72b6\u6001\u6216\u5916\u6e90\u6027\u7ed9\u4e88\u7c7b\u56fa\u9187\u3002\u2021\u808c\u8089\u91cf\u51cf\u5c11\u5bfc\u81f4\u808c\u9150\u751f\u6210\u4e0b\u964d\u6216\u808c\u9150\u5206\u6ccc\u51cf\u5c11\u6216\u7279\u5b9a\u836f\u7269\u5bfc\u81f4\u80be\u5916\u6e05\u9664\u7684\u5065\u5eb7\u4eba\u7fa4\uff0c\u5e94\u8003\u8651eGFRcys \u800c\u4e0d\u662feGFRcr-cys\u3002<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.2.2.2\uff1a\u82e5\u9700\u66f4\u51c6\u786e\u7684GFR\u6307\u5bfc\u6cbb\u7597\u51b3\u7b56\uff0c\u5e94\u4f7f\u7528\u5916\u6e90\u6027\u6ee4\u8fc7\u6807\u5fd7\u7269\u7684\u8840\u6d46\u6216\u5c3f\u6db2\u6e05\u9664\u7387\u68c0\u6d4bGFR\uff08Table 9\uff09<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.2.2.3\uff1a\u4e86\u89e3eGFR\u548c\u68c0\u6d4b\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\uff08mGFR\uff09\u7684\u4ef7\u503c\u548c\u5c40\u9650\u6027\uff0c\u4ee5\u53ca\u5f71\u54cdSCr\u548c\u80f1\u6291\u7d20C\u68c0\u6d4b\u7684\u53d8\u5f02\u6027\u548c\u56e0\u7d20<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.2.2.4\uff1aSCr\u6c34\u5e73\u7684\u89e3\u91ca\u9700\u8003\u8651\u996e\u98df\u6444\u5165\u60c5\u51b5<\/p>\n<p>Table 8 | \u4f7f\u7528\u5149\u6291\u7d20C\u9002\u5e94\u75c7<\/p>\n<\/p>\n<p>eGFR&nbsp;\u4f30\u8ba1\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\uff1beGFRcr&nbsp;\u808c\u9150\u4f30\u8ba1GFR\uff1beGFRcr-cys&nbsp;\u808c\u9150\u548c\u80f1\u6291\u7d20C\u4f30\u8ba1GFR\uff1bGFR&nbsp;\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\uff1bmGFR&nbsp;\u68c0\u6d4b\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\uff1bSCr&nbsp;\u8840\u6e05\u808c\u9150\uff1bSCys&nbsp;\u8840\u6e05\u80f1\u6291\u7d20C<\/p>\n<p>a Adingwupu\u7b49\u603b\u7ed3\u62a5\u544a\uff08Nephrol Dial Transplant. 2017;32:497\u2013507.\uff09<\/p>\n<p>b III\u7ea7\u80a5\u80d6\u56e0\u5730\u533a\u800c\u5f02\uff0c\u4f46\u901a\u5e38\u4f53\u91cd\u6307\u6570&gt;40\u6216&gt;35 kg\/m<sup>2<\/sup><\/p>\n<p>c \u5206\u89e3\u4ee3\u8c22\u6d88\u8017\u6027\u75be\u75c5\u53ef\u80fd\u5305\u62ec\u80ba\u7ed3\u6838\u3001\u827e\u6ecb\u75c5\u3001\u6076\u6027\u8840\u6db2\u75c5\u548c\u4e25\u91cd\u76ae\u80a4\u75c5\u3002\u65e0\u68c0\u6d4b\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\uff08mGFR\uff09\u6570\u636e\u76f4\u63a5\u8bc4\u4ef7<\/p>\n<p>Table 9 | \u4f30\u8ba1GFR\u548c\u68c0\u6d4bGFR\u6bd4\u8f83<\/p>\n<\/p>\n<p>GFR&nbsp;\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\uff1bSCr&nbsp;\u8840\u6e05\u808c\u9150<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.2.2.5:&nbsp;\u8bc4\u4f30\u52a8\u6001\u53d8\u5316\u7684GFR\uff0c\u5e94\u8bc4\u4f30eGFR\u53d1\u751f\u8bef\u5dee\u7684\u53ef\u80fd<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.2.2.6:&nbsp;\u67d0\u4e9b\u60c5\u51b5\u5e94\u8003\u8651\u4f7f\u7528\u57fa\u4e8e\u80f1\u6291\u7d20C\u7684\u4f30\u8ba1\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\uff08eGFRcys\uff09<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.2.2.7:&nbsp;\u4e86\u89e3eGFRcr\u548ceGFRcys\u5dee\u5f02\u7684\u542b\u4e49\uff0c\u56e0\u4e3a\u5dee\u5f02\u5728\u8d8b\u52bf\u548c\u5e45\u5ea6\u4e0a\u5747\u53ef\u80fd\u63d0\u4f9b\u4fe1\u606f<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.2.2.8:&nbsp;\u82e5\u65e0\u6cd5\u83b7\u5f97mGFR\u4e14eGFRcr-cys\u4e0d\u51c6\u786e\uff0c\u5e94\u8003\u8651\u5b9a\u65f6\u6536\u96c6\u5c3f\u6db2\u68c0\u6d4b\u808c\u9150\u6e05\u9664\u73871.2.3\u4e34\u5e8a\u5b9e\u9a8c\u5ba4\u6307\u5bfc\u5b9e\u8df5\u8981\u70b91.2.3.1:&nbsp;\u4e25\u683c\u6267\u884cTable 11\u6982\u8ff0\u7684\u5b9e\u9a8c\u5ba4\u5de5\u4f5c\u6807\u51c6\uff0c\u786e\u4fdd\u808c\u9150\u548c\u80f1\u6291\u7d20\u8bc4\u4f30GFR\u7684\u51c6\u786e\u6027\u548c\u53ef\u9760\u6027eGFR \u4f30\u8ba1\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\uff1beGFRcr-cys \u4f9d\u636e\u808c\u9150\u548c\u80f1\u6291\u7d20C\u4f30\u8ba1\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\uff1bGFR\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\uff1bSCr \u8840\u6e05\u808c\u9150\u5b9e\u8df5\u8981\u70b91.2.3.2:&nbsp;\u6709\u6761\u4ef6\u7684\u4e34\u5e8a\u5b9e\u9a8c\u5ba4\u53ef\u8003\u8651\u540c\u65f6\u68c0\u6d4b\u808c\u9150\u548c\u80f1\u6291\u7d20\uff0c\u4f5c\u4e3a\u5185\u90e8\u6216\u53c2\u8003\u68c0\u6d4b\u5bf9\u7167\u7279\u6b8a\u60c5\u51b5\u513f\u7ae5\u6ce8\u610f\u4e8b\u9879<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.2.3.3:&nbsp;\u68c0\u6d4b\u5a74\u5e7c\u513f\u808c\u9150\u7684\u5b9e\u9a8c\u5ba4\uff0c\u5fc5\u987b\u786e\u4fdd\u8d28\u91cf\u63a7\u5236\u8fc7\u7a0b\u5305\u62ec\u9884\u671f\u503c\u8303\u56f4\u6700\u4f4e\u9650<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.2.3.4\uff1a\u9274\u4e8eJaffe \u68c0\u6d4b\u975e\u808c\u9150\u8272\u539f\u5bf9\u513f\u7ae5\u808c\u9150\u68c0\u6d4b\u76f8\u5bf9\u8d21\u732e\u8f83\u9ad8\uff0c\u4ee5\u53ca\u65b0\u751f\u513f\u671f\u9ec4\u75b8\u548c\u6eb6\u8840\u6837\u672c\u60a3\u75c5\u7387\u8f83\u9ad8\uff0c\u5e94\u8003\u8651\u513f\u7ae5\u4e00\u81f4\u4f7f\u7528\u9176\u6cd5\u68c0\u6d4b\u808c\u9150<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.2.3.5\uff1a2\u5c81\u4ee5\u4e0a\u513f\u7ae5\u548c\u9752\u5c11\u5e74\uff0ceGFRcr&nbsp;&lt;90 ml\/min\/1.73m<sup>2<\/sup>\u53ef\u6807\u8bb0\u4e3a\u4f4e<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.2.4.1\uff1a\u5730\u7406\u533a\u57df\u5185\u5e94\u4f7f\u7528\u76f8\u540c\u65b9\u7a0b\uff08\u4f9d\u636e\u5f53\u5730\u5b9a\u4e49\u5982\u5927\u9646\u3001\u56fd\u5bb6\u3001\u5730\u533a\u4e14\u5c3d\u53ef\u80fd\u5927\uff09\uff0c\u4f46\u8fd9\u4e9b\u533a\u57df\u5185\u6210\u4eba\u548c\u513f\u7ae5\u7684\u65b9\u7a0b\u53ef\u80fd\u6709\u6240\u4e0d\u540c<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.2.4.2\uff1a\u8ba1\u7b97eGFR\u5e94\u907f\u514d\u4f7f\u7528\u79cd\u65cf\u53c2\u6570<\/p>\n<p>\u7279\u6b8a\u60c5\u51b5<\/p>\n<p>\u513f\u7ae5\u6ce8\u610f\u4e8b\u9879\u5b9e\u8df5\u8981\u70b91.2.4.3\uff1a\u4f7f\u7528\u5df2\u5728\u7c7b\u4f3c\u4eba\u7fa4\u5f00\u53d1\u6216\u9a8c\u8bc1\u7684\u516c\u5f0f\u8bc4\u4f30\u513f\u7ae5GFR1.3 \u5c3f\u767d\u86cb\u767d\u8bc4\u4f301.3.1 \u5185\u79d1\u533b\u751f\u548c\u5176\u4ed6\u533b\u7597\u536b\u751f\u4eba\u5458\u6307\u5bfc<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.3.1.1\uff1a\u4f7f\u7528\u4ee5\u4e0b\u65b9\u6cd5\u521d\u6b65\u68c0\u6d4b\u5c3f\u767d\u86cb\u767d\uff08\u6309\u504f\u597d\u964d\u5e8f\u6392\u5217\uff09\u3002\u6240\u6709\u60c5\u51b5\u4e0b\uff0c\u6210\u4eba\u548c\u513f\u7ae5\u5747\u9996\u9009\u4e2d\u6bb5\u6668\u5c3f\u3002<\/p>\n<p>\u2460\u5c3fACR\u6216\u2461\u767d\u86cb\u767d\u548cACR\u5c3f\u6db2\u5206\u6790\u8bd5\u5242\u6761\uff0c\u6709\u81ea\u52a8\u8bfb\u6570\u529f\u80fd\u5982\u679c\u68c0\u6d4b\u5c3f\u86cb\u767d\uff0c\u4f7f\u7528\u4ee5\u4e0b\u65b9\u6cd5\uff1a\u2460\u5c3f\u86cb\u767d\/\u808c\u9150\u6bd4\uff08PCR\uff09\u2461\u5c3f\u603b\u86cb\u767d\u81ea\u52a8\u8bfb\u6570\u5206\u6790\u8bd5\u7eb8\u6761\u6216\u2462\u5c3f\u603b\u86cb\u767d\u624b\u5de5\u8bfb\u6570\u5206\u6790\u8bd5\u7eb8\u6761\u5b9e\u8df5\u8981\u70b91.3.1.2\uff1a\u4f7f\u7528\u4e0d\u592a\u51c6\u786e\u7684\u65b9\u6cd5\u68c0\u6d4b\u5c3f\u767d\u86cb\u767d\uff0c\u5e94\u4e88\u66f4\u51c6\u786e\u65b9\u6cd5\u6821\u6b63<\/p>\n<ul>\n<li>\u5c3f\u767d\u86cb\u767d\u548c\/\u6216\u86cb\u767d\u5c3f\u8bd5\u7eb8\u6761\u9633\u6027\u5e94\u901a\u8fc7\u5b9e\u9a8c\u5ba4\u5b9a\u91cf\u68c0\u6d4b\u786e\u8ba4\uff0c\u5e76\u5c3d\u53ef\u80fd\u4ee5\u5c3f\u808c\u9150\u6bd4\u4f8b\u8868\u793a\uff08\u5373\u521d\u59cb\u534a\u5b9a\u91cf\u8bd5\u9a8c\u5448\u9633\u6027\uff0c\u5219\u5e94\u5b9a\u91cfACR\u6216PCR\uff09<\/li>\n<li>\u968f\u673a\u4e0d\u5b9a\u65f6\u5c3f\u6db2ACR\u226530mg \/g\uff08\u22653mg \/mmol\uff09\uff0c\u5e94\u968f\u5373\u4e2d\u6bb5\u6668\u5c3f\u68c0\u6d4b\u786e\u8ba4<\/li>\n<\/ul>\n<p>\u5b9e\u8df5\u8981\u70b91.3.1.3\uff1a\u4e86\u89e3\u53ef\u80fd\u5f71\u54cd\u5c3f\u767d\u86cb\u767d\u548c\u5c3f\u808c\u9150\u68c0\u6d4b\u7ed3\u679c\u7684\u56e0\u7d20\uff0c\u6309\uff08Table 16\uff09\u8fdb\u884c\u786e\u8ba4\u6027\u68c0\u6d4b<\/p>\n<p>\u7279\u6b8a\u60c5\u51b5<\/p>\n<p>\u513f\u7ae5\u6ce8\u610f\u4e8b\u9879<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.3.1.4\uff1a\u513f\u7ae5\u5e94\u901a\u8fc7\u6668\u5c3f\u6837\u672c\u521d\u6b65\u68c0\u6d4b\u5c3f\u767d\u86cb\u767d\u548c\u5c3f\u86cb\u767d\uff08\u6309\u504f\u597d\u964d\u5e8f\u6392\u5217\uff09\uff1a\u2460\u5c3fPCR\u548c\u5c3fACR\u2461\u5c3f\u603b\u86cb\u767d\u548c\u767d\u86cb\u767d\u81ea\u52a8\u8bfb\u6570\u8bd5\u7eb8\u5206\u6790\u6761\u6216\u2462\u5c3f\u603b\u86cb\u767d\u548c\u767d\u86cb\u767d\u624b\u5de5\u8bfb\u6570\u8bd5\u7eb8\u5206\u6790\u67611.3.2 \u4e34\u5e8a\u5b9e\u9a8c\u5ba4\u6307\u5357\u5b9e\u8df5\u8981\u70b91.3.2.1\uff1a\u5b9e\u9a8c\u5ba4\u62a5\u544a\u548c\u5904\u7406\u6807\u51c6\u89c1Table 17\uff0c\u786e\u4fdd\u5c3f\u6db2\u6837\u672c\u8bc4\u4f30\u7ed3\u679c\u7684\u51c6\u786e\u6027\u548c\u53ef\u9760\u6027<\/p>\n<p>ACR \u767d\u86cb\u767d\/\u808c\u9150\u6bd4\u503c\uff1bCV \u53d8\u5f02\u7cfb\u6570&nbsp; &nbsp; &nbsp;\u5b9e\u8df5\u8981\u70b91.3.2.2\uff1a\u5c3f\u767d\u86cb\u767d\u548c\u808c\u9150\u5916\u90e8\u8d28\u91cf\u8bc4\u4f30\u65b9\u6848\/\u7a0b\u5e8f\uff08\u5305\u62ec\u8ba1\u7b97ACR\uff09\u662f\u5b9e\u9a8c\u5ba4\u7684\u9996\u9009\u505a\u6cd5<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.4.1\uff1aPOCT\u68c0\u6d4b\u808c\u9150\u548c\u5c3f\u767d\u86cb\u767d\uff0c\u5e94\u786e\u4fdd\u6837\u672c\u91c7\u96c6\u548c\u8bbe\u5907\u6027\u80fd\u4e8e\u5206\u6790\u524d\u3001\u4e2d\u548c\u540e\u8d28\u91cf\u6807\u51c6\u76f8\u540c\uff0c\u5305\u62ec\u5916\u90e8\u8d28\u91cf\u8bc4\u4f30\u548c\u7ed3\u679c\u89e3\u91ca<\/p>\n<p>\u5b9e\u8df5\u8981\u70b91.4.2\uff1aPOCT\u68c0\u6d4b\u808c\u9150\u53ef\u83b7\u53d6GFR\u4f30\u8ba1\u503c\uff0c\u5e94\u4f7f\u7528\u533a\u57df\u5185\u4e00\u81f4\u6027\u65b9\u7a0b\u5b9e\u8df5\u8981\u70b91.4.3\uff1aPOCT\u68c0\u6d4b\u5c3f\u86cb\u767d\u65f6\uff0c\u5206\u6790\u808c\u9150\u548c\u751f\u6210ACR\u8bbe\u5907\u7684\u6027\u80fd\u4e5f\u5f88\u91cd\u8981\u3002\u8bc4\u4f30POCT ACR\u8bbe\u5907\u68c0\u6d4b\u53d1\u751f\u663e\u8457\u86cb\u767d\u5c3f\uff08ACR\u226530mg\/g\u6216\u2265 3 mg\/mmol\uff0985%\u9633\u6027\u7ed3\u679c\u7684\u6027\u80fd\uff0c\u5e94\u4f5c\u4e3a\u8bc4\u4f30\u548c\u8003\u8651\u4f7f\u7528\u8be5\u8bbe\u5907\u7684\u4e00\u90e8\u5206<\/p>\n<p>\u7b2c2\u7ae0\uff1aCKD\u4eba\u7fa4\u98ce\u9669\u8bc4\u4f30<\/p>\n<p>2.1\u57fa\u4e8eGFR\u548cACR\u5206\u7c7b\u76d1\u6d4bCKD\u8fdb\u5c55\u6982\u8ff0<\/p>\n<p>\u5b9e\u8df5\u8981\u70b92.1.1\uff1aCKD\u4eba\u7fa4\u81f3\u5c11\u6bcf\u5e74\u8bc4\u4f30\u4e00\u6b21\u6210\u4eba\u5c3f\u86cb\u767d\u6216\u513f\u7ae5\u5c3f\u767d\u86cb\u767d\/\u5c3f\u86cb\u767d\u4ee5\u53caGFR\u5b9e\u8df5\u8981\u70b92.1.2\uff1aCKD\u8fdb\u5c55\u98ce\u9669\u8f83\u9ad8\uff0c\u68c0\u6d4b\u7ed3\u679c\u5f71\u54cd\u6cbb\u7597\u51b3\u7b56\uff0c\u5e94\u5e38\u8bc4\u4f30\u86cb\u767d\u5c3f\u548cGFR\u5b9e\u8df5\u8981\u70b92.1.3\uff1aCKD\u60a3\u8005eGFR\u68c0\u6d4b\u7ed3\u679c\u8d85\u9884\u671f\u6539\u53d8\uff1e20%\uff0c\u5e94\u4e88\u4ee5\u8bc4\u4f30\u5b9e\u8df5\u8981\u70b92.1.4\uff1aCKD\u60a3\u8005\u79ef\u6781\u6cbb\u7597\u521d\u59cb\u8840\u6d41\u52a8\u529b\u5b66\u6539\u53d8\uff0cGFR\u964d\u4f4e&gt;30%\u8d85\u9884\u671f\u5f02\u5e38\uff0c\u5e94\u4e88\u4ee5\u8bc4\u4f30<\/p>\n<p>\u5b9e\u8df5\u8981\u70b92.1.5\uff1aCKD\u60a3\u8005\u5c3f\u86cb\u767d\u76d1\u6d4b\uff0cACR\u7ffb\u500d\u8d85\u5b9e\u9a8c\u5ba4\u53d8\u5f02\uff0c\u5e94\u4e88\u4ee5\u8bc4\u4f30&nbsp; &nbsp; &nbsp;\u5b9e\u8df5\u8981\u70b92.2.1\uff1a\u9664eGFR\u6216\u5c3fACR\u6807\u51c6\u548c\u5176\u4ed6\u4e34\u5e8a\u60c5\u51b5\u5916\uff0c5\u5e74\u80be\u8870\u7aed\u98ce\u96693%-5%\u5e94\u8f6c\u8bca\u81f3\u80be\u5185\u79d1<\/p>\n<p>\u5b9e\u8df5\u8981\u70b92.2.2\uff1a\u9664eGFR\u6807\u51c6\u548c\u5176\u4ed6\u4e34\u5e8a\u60c5\u51b5\u5916\uff0c2\u5e74\u80be\u8870\u7aed\u98ce\u9669&gt;10%\u5e94\u542f\u52a8\u591a\u5b66\u79d1\u6cbb\u7597<\/p>\n<p>\u5b9e\u8df5\u8981\u70b92.2.3\uff1a2\u5e74\u80be\u8870\u7aed\u98ce\u9669&gt;40%\u5e94\u542f\u52a8\u60a3\u8005\u6559\u80b2\u3001\u80be\u810f\u66ff\u4ee3\u6cbb\u7597\uff08KRT\uff09\u51c6\u5907\u5982\u8840\u7ba1\u901a\u8def\u89c4\u5212\u6216\u8f6c\u8bca\u81f3\u79fb\u690d\u673a\u6784\uff0c\u4ee5\u53ca\u57fa\u4e8eeGFR\u7684\u6807\u51c6\u548c\u5176\u4ed6\u4e34\u5e8a\u60c5\u51b5<\/p>\n<p>\u5b9e\u8df5\u8981\u70b92.2.4\uff1a\u6ce8\u610f\uff0cCKD G3\u2013G5\u98ce\u9669\u9884\u6d4b\u65b9\u7a0b\u53ef\u80fd\u4e0d\u9002\u7528\u4e8eCKD G1\u2013G2\u5b9e\u8df5\u8981\u70b92.2.5\uff1a\u514d\u75ab\u7403\u86cb\u767dA\u80be\u75c5\uff08IgAN\uff09\u548c\u5e38\u67d3\u8272\u4f53\u663e\u6027\u591a\u56ca\u80be\u75c5\uff08ADPKD\uff09\u5e94\u4f7f\u7528\u75be\u75c5\u7279\u5f02\u6027\u3001\u7ecf\u5916\u90e8\u9a8c\u8bc1\u7684\u9884\u6d4b\u65b9\u7a0b2.3 CKD\u4eba\u7fa4\u5fc3\u8840\u7ba1\u98ce\u9669\u9884\u6d4b\u5b9e\u8df5\u8981\u70b92.3.1\uff1a\u6307\u5bfcCKD\u60a3\u8005\u9884\u9632\u6cbb\u7597\u7684\u5fc3\u8840\u7ba1\u98ce\u9669\u9884\u6d4b\u6a21\u578b\uff08\u5916\u90e8\u9a8c\u8bc1\uff09\uff0c\u5e94\u57fa\u4e8eCKD\u4eba\u7fa4\u5f00\u53d1\uff0c\u6216\u5305\u62eceGFR\u548c\u86cb\u767d\u5c3f\u7684\u6a21\u578b<\/p>\n<p>\u5b9e\u8df5\u8981\u70b92.3.2\uff1a\u6307\u5bfcCKD\u4eba\u7fa4\u7ba1\u7406\u7684\u6b7b\u4ea1\u98ce\u9669\u9884\u6d4b\u6a21\u578b\uff08\u5916\u90e8\u9a8c\u8bc1\uff09\uff0c\u5e94\u4f7f\u7528\u4e13\u95e8\u9488\u5bf9CKD\u4eba\u7fa4\u5f00\u53d1\u5168\u56e0\u6b7b\u4ea1\u7387\u6a21\u578b<\/p>\n<p>2.3 CKD\u4eba\u7fa4\u5fc3\u8840\u7ba1\u98ce\u9669\u9884\u6d4b\u5b9e\u8df5\u8981\u70b92.3.1\uff1a\u6307\u5bfcCKD\u60a3\u8005\u9884\u9632\u6cbb\u7597\u7684\u5fc3\u8840\u7ba1\u98ce\u9669\u9884\u6d4b\u6a21\u578b\uff08\u5916\u90e8\u9a8c\u8bc1\uff09\uff0c\u5e94\u57fa\u4e8eCKD\u4eba\u7fa4\u5f00\u53d1\uff0c\u6216\u5305\u62eceGFR\u548c\u86cb\u767d\u5c3f\u7684\u6a21\u578b\u5b9e\u8df5\u8981\u70b92.3.2\uff1a\u6307\u5bfcCKD\u4eba\u7fa4\u7ba1\u7406\u7684\u6b7b\u4ea1\u98ce\u9669\u9884\u6d4b\u6a21\u578b\uff08\u5916\u90e8\u9a8c\u8bc1\uff09\uff0c\u5e94\u4f7f\u7528\u4e13\u95e8\u9488\u5bf9CKD\u4eba\u7fa4\u5f00\u53d1\u5168\u56e0\u6b7b\u4ea1\u7387\u6a21\u578b<\/p>\n<p>\u7b2c3\u7ae0\uff1a\u5ef6\u7f13CKD\u8fdb\u5c55\u548c\u5e76\u53d1\u75c7\u7ba1\u7406<\/p>\n<p>3.1 CKD\u6cbb\u7597\u548c\u98ce\u9669\u8c03\u6574<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.1.1\uff1a\u91c7\u7528\u7efc\u5408\u6cbb\u7597\u7b56\u7565\u7ba1\u7406CKD\uff0c\u964d\u4f4eCKD\u53ca\u76f8\u5173\u5e76\u53d1\u75c7\u8fdb\u5c55\u98ce\u9669\uff08Figure 17\uff09<\/p>\n<\/p>\n<p>Figure 17 | 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2021\u5e74\u6162\u6027\u80be\u810f\u75c5\u8840\u538b\u7ba1\u7406\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\uff0c\u5e76\u5f3a\u8c03\u4ee5\u4e0b\u6307\u5357\uff1a<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.4.2\uff1aCKD\u513f\u7ae5\uff0cABPM\u76d1\u6d4bBP\u6bcf\u5e74\u4e00\u6b21\uff0c\u6807\u51c6\u5316\u8bca\u5ba4\u76d1\u6d4bBP\u6bcf3-6\u6708\u4e00\u6b21<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.4.3\uff1aCKD\u513f\u7ae5ABPM\u4e0d\u80fd\uff0c\u53ef\u9009\u62e9\u6807\u51c6\u5316\u624b\u52a8\u8bca\u5ba4\u6536\u7f29\u538b\uff0c\u76ee\u6807\u503c\u4e3a\u5e74\u9f84\u3001\u6027\u522b\u548c\u8eab\u9ad8\u5339\u914d\u768450-75%\uff08\u9664\u975e\u5b58\u5728\u4f4e\u8840\u538b\u4f53\u5f81\u6216\u75c7\u72b6\u9650\u5236\uff093.5\u8840\u7cd6\u63a7\u5236\u5177\u4f53\u63a8\u8350\u3001\u5b9e\u8df5\u8981\u70b9\u548c\u7814\u7a76\u63a8\u8350\u8bf7\u53c2\u7167KDIGO 2022\u5e74\u6162\u6027\u80be\u810f\u75c5\u4f34\u7cd6\u5c3f\u75c5\u7ba1\u7406\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\u30023.6\u80be\u7d20-\u8840\u7ba1\u7d27\u5f20\u7d20\u7cfb\u7edf\u6291\u5236\u5242\u5de5\u4f5c\u7ec4\u91cd\u70b9\u63a8\u8350KDIGO 2021\u6162\u6027\u80be\u810f\u75c5\u8840\u538b\u7ba1\u7406\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\uff0c\u4ee5\u53caKDIGO 2021\u6162\u6027\u80be\u810f\u75c5\u8840\u538b\u7ba1\u7406\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\u548cKDIGO 2022\u6162\u6027\u80be\u810f\u75c5\u4f34\u7cd6\u5c3f\u75c5\u7ba1\u7406\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\u4e2dRASi\u6cbb\u7597\u7684\u5b9e\u8df5\u8981\u70b9\u3002\u5de5\u4f5c\u7ec4\u8003\u8651\u4e86\u51e0\u9879\u63a8\u8350\uff0c\u5373\u4f7f\u65e0\u9ad8\u8840\u4e5f\u9002\u7528\uff0c\u5e76\u4fee\u6539\u4e86BP\u6307\u5357\u63a8\u8350\u4ee5\u53d6\u6d88\u8fd9\u4e00\u8981\u6c42\u3002\u91cd\u70b9\u63a8\u8350\u548c\u5b9e\u8df5\u8981\u70b9\u5982\u4e0b\uff1a<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.6.1\uff1aRASi\uff08ACEi\u6216ARB\uff09\u5e94\u4f7f\u7528\u6700\u5927\u53ef\u8010\u53d7\u6279\u51c6\u5242\u91cf\u4ee5\u5b9e\u73b0\u83b7\u76ca\uff08\u4e34\u5e8a\u8bd5\u9a8c\u5df2\u8bc1\u5b9e\u4e0a\u8ff0\u5242\u91cf\u7684\u76ca\u5904\uff09<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.6.2\uff1a\u4f9d\u636eGFR\u548c\u8840\u6e05\u94be\u6c34\u5e73\uff0c\u5e94\u4e8e\u542f\u52a8\u6216\u589e\u52a0RASi\u5242\u91cf2-4\u5468\u5185\u76d1\u6d4b\u8840\u538b\u3001\u8840\u6e05\u808c\u9150\u548c\u8840\u6e05\u94be\u7684\u53d8\u5316<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.6.3\uff1aRASi\u76f8\u5173\u9ad8\u94be\u8840\u75c7\u901a\u5e38\u53ef\u901a\u8fc7\u964d\u4f4e\u8840\u6e05\u94be\u63a7\u5236\uff0c\u800c\u975e\u51cf\u5c11RASi\u5242\u91cf\u6216\u505c\u7528<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.6.4\uff1a\u7ee7\u7eedACEi\u6216ARB\u6cbb\u7597\uff0c\u9664\u975e\u542f\u52a8\u6cbb\u7597\u6216\u589e\u52a0\u5242\u91cf4\u5468\u5185\u8840\u6e05\u808c\u9150\u5347\u9ad8\u8d85\u8fc730%\u5b9e\u8df5\u8981\u70b93.6.5\uff1a\u5b58\u5728\u75c7\u72b6\u6027\u4f4e\u8840\u538b\u6216\u836f\u7269\u6cbb\u7597\u540e\u9ad8\u94be\u8840\u75c7\u65e0\u6cd5\u63a7\u5236\u6216\u6cbb\u7597\u80be\u8870\u7aed\u62df\u51cf\u5c11\u5c3f\u6bd2\u75c7\u75c7\u72b6\uff08\u4f30\u8ba1\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387[eGFR] &lt;15 ml\/min\/1.73 m<sup>2<\/sup>\uff09\uff0c\u5e94\u8003\u8651\u51cf\u5c11ACEi\u6216ARB\u5242\u91cf\u6216\u505c\u7528<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.6.6\uff1a\u8003\u8651\u67d0\u4e9b\u9002\u5e94\u75c7\uff08\u5982\u6cbb\u7597\u9ad8\u8840\u538b\u6216\u4f4e\u5c04\u8840\u5206\u6570\u5fc3\u529b\u8870\u7aed\uff09CKD\u4f34\u6b63\u5e38\u81f3\u8f7b\u5ea6\u5c3f\u86cb\u767d\uff08A1\uff09\u5347\u9ad8\u542f\u52a8RASi\uff08ACEi\u6216ARB\uff09\u6cbb\u7597<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.6.7\uff1a\u5373\u4f7feGFR\u4f4e\u4e8e30ml \/min \/1.73m<sup>2<\/sup>, CKD\u4ecd\u5e94\u7ee7\u7eed\u4f7f\u7528ACEi\u6216ARB<\/p>\n<p>3.7\u94a0-\u8461\u8404\u7cd6\u5171\u8f6c\u8fd0\u86cb\u767d2\u6291\u5236\u5242\uff08SGLT2i\uff09<\/p>\n<p>\u5de5\u4f5c\u7ec4\u8d5e\u540cKDIGO 2022\u6162\u6027\u80be\u810f\u75c5\u4f34\u7cd6\u5c3f\u75c5\u7ba1\u7406\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\uff1a\u201c\u63a8\u8350SGLT2i\u7528\u4e8e\u6cbb\u75972\u578b\u7cd6\u5c3f\u75c5\uff08T2D\uff09\u3001CKD\u4f34eGFR\u226520 ml\/min\/1.73m<sup>2<\/sup>\uff081A\uff09\u201d\u3002\u4e0d\u8fc7\uff0c\u76ee\u524d\u6307\u5357\u4e3a\u6210\u4ebaCKD\u63d0\u4f9b\u4e86\u66f4\u901a\u7528\u76841A\u63a8\u8350\u3002\u6307\u5357\u8fd8\u5f3a\u8c03KDIGO\u7cd6\u5c3f\u75c5\u6307\u5357\u4e2dCKD\u4f34\u7cd6\u5c3f\u75c5\u7ba1\u7406\u5b9e\u8df5\u8981\u70b9\u4e5f\u9002\u7528\u4e8eCKD\u4e0d\u4f34\u7cd6\u5c3f\u75c5\uff1a<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.7.1\uff1a\u4e00\u65e6SGLT2i\u542f\u52a8\uff0c\u5373\u4f7feGFR\u964d\u81f320 ml\/min\/1.73m<sup>2<\/sup>\u4ee5\u4e0b\uff0c\u4ecd\u53ef\u7ee7\u7eed\u4f7f\u7528SGLT2i\uff0c\u9664\u975e\u65e0\u6cd5\u8010\u53d7\u6216\u5f00\u59cbKRT\u5b9e\u8df5\u8981\u70b93.7.2\uff1a\u957f\u65f6\u95f4\u7981\u98df\u3001\u624b\u672f\u6216\u4e25\u91cd\u75be\u75c5\u72b6\u6001\uff08\u916e\u75c7\u9ad8\u98ce\u9669\uff09\uff0c\u53ef\u8003\u8651\u505c\u7528SGLT2i<\/p>\n<p>&nbsp; &nbsp;&nbsp;\u5b9e\u8df5\u8981\u70b93.7.3\uff1a\u542f\u52a8SGLT2i\u6216\u4f7f\u7528\uff0c\u4e0d\u5fc5\u6539\u53d8CKD\u76d1\u6d4b\u9891\u7387\uff0c\u542f\u52a8\u65f6eGFR\u53ef\u9006\u6027\u4e0b\u964d\u901a\u5e38\u4e0d\u662f\u505c\u7528\u6307\u5f81<\/p>\n<\/p>\n<p>3.8\u76d0\u76ae\u8d28\u6fc0\u7d20\u53d7\u4f53\u62ee\u6297\u5242\uff08MRA\uff09<\/p>\n<p>\u5de5\u4f5c\u7ec4\u91cd\u70b9\u4ecb\u7ecd\u4e86KDIGO 2022\u6162\u6027\u80be\u810f\u75c5\u4f34\u7cd6\u5c3f\u75c5\u7ba1\u7406\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\u7684\u5173\u952e\u63a8\u8350\u548c\u5b9e\u8df5\u8981\u70b9\u3002<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.8.1\uff1a\u8fdb\u5c55\u6027CKD\u4f34\u9ad8\u98ce\u9669\u5fc3\u8840\u7ba1\u4e8b\u4ef6\u6210\u4ebaT2D\uff0c\u5c3d\u7ba1\u7ed9\u4e88\u5176\u4ed6\u6807\u51c6\u6cbb\u7597\uff0c\u4f46\u4ecd\u6301\u7eed\u6027\u767d\u86cb\u767d\u5c3f\u6700\u9002\u5408\u975e\u753e\u4f53MRA<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.8.2\uff1a\u975e\u753e\u4f53MRA\u53ef\u8054\u5408RASi\u548cSGLT2i\u6cbb\u7597\u6210\u4ebaT2D\u548cCKD\u5b9e\u8df5\u8981\u70b93.8.3\uff1a\u4e3a\u964d\u4f4e\u9ad8\u94be\u8840\u75c7\u98ce\u9669\uff0c\u9009\u62e9\u8840\u6e05\u94be\u59cb\u7ec8\u6b63\u5e38\u7684\u60a3\u8005\uff0c\u5e76\u542f\u52a8\u975e\u753e\u4f53MRA \u540e\u5b9a\u671f\u76d1\u6d4b\u8840\u6e05\u94be\uff08Figure 26\uff09Figure 26&nbsp;|&nbsp;\u975e\u753e\u4f53\u76d0\u76ae\u8d28\u6fc0\u7d20\u53d7\u4f53\u62ee\u6297\u5242\uff08MRA\uff09\uff08\u975e\u5948\u5229\u916e\uff09\u6cbb\u7597\u671f\u95f4\u8840\u94be\u76d1\u6d4b\u3002\u6e90\u4e8e\u975e\u5948\u5229\u916e\u51cf\u5c11\u7cd6\u5c3f\u75c5\u80be\u75c5\u80be\u8870\u7aed\u548c\u75be\u75c5\u8fdb\u5c55\uff08FIDELIO-DKD\uff09\u548c\u975e\u5948\u5229\u916e\u51cf\u5c11\u7cd6\u5c3f\u75c5\u80be\u75c5\u5fc3\u8840\u7ba1\u6b7b\u4ea1\u7387\u548c\u53d1\u75c5\u7387\uff08FIGARO-DKD\uff09\u7814\u7a76\u3002\u5de5\u4f5c\u7ec4\u8ba4\u4e3a\u4e0a\u8ff0\u94be\u9608\u503c\u8f83\u4fdd\u5b88\uff0c\u94be\u6d53\u5ea65.5-6.0 mmol\/l\u7ee7\u7eed\u4f7f\u7528MRA\u53ef\u80fd\u9002\u5f53\u3002\u4e0a\u8ff0\u6d41\u7a0b\u4e5f\u53ef\u7528\u4e8e\u753e\u4f53MRA\u3002\u7f8e\u56fd\u98df\u54c1\u548c\u836f\u7269\u7ba1\u7406\u5c40\uff08FDA\uff09\u5df2\u6279\u51c6K+&lt; 5.0 mmol\/l\u542f\u52a8\u975e\u5948\u5229\u916e\u3002K+&lt; 5.0 mmol\/l\u4ee5\u8bd5\u9a8c\u8bbe\u8ba1\u548cFDA\u8bf4\u660e\u4e66\u4e3a\u6307\u5bfc\uff0c\u4e0d\u8fc7\u5176\u4ed6\u56fd\u5bb6\u53ef\u80fd\u6709\u6240\u4e0d\u540c\u3002\u8840\u6e05\u94be\u548c\u8840\u6e05\u808c\u9150\/\u4f30\u8ba1\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\uff08eGFR\uff09\u5e94\u540c\u65f6\u76d1\u6d4b\u3002\u8f6c\u8f7d\u81eaKDIGO 2022\u6162\u6027\u80be\u810f\u75c5\u4f34\u7cd6\u5c3f\u75c5\u7ba1\u7406\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\u3002Kidney Int. 2022;102:S1\u2013S127<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.8.4\uff1a\u9009\u62e9\u975e\u753e\u4f53MRA\u5e94\u4f18\u5148\u8003\u8651\u80be\u810f\u6216\u5fc3\u8840\u7ba1\u83b7\u76ca<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.8.5\uff1a\u753e\u4f53MRA\u53ef\u7528\u4e8e\u6cbb\u7597\u5fc3\u529b\u8870\u7aed\u3001\u919b\u56fa\u916e\u589e\u591a\u75c7\u6216\u96be\u6cbb\u6027\u9ad8\u8840\u538b\uff0c\u4f46\u53ef\u80fd\u5bfc\u81f4\u9ad8\u94be\u8840\u75c7\u6216\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\u53ef\u9006\u6027\u4e0b\u964d\uff0c\u5c24\u5176GFR\u4f4e\u7684\u4eba\u7fa4<\/p>\n<p>3.9\u80f0\u9ad8\u8840\u7cd6\u7d20\u6837\u80bd-1\u53d7\u4f53\u6fc0\u52a8\u5242\uff08GLP-1 RA\uff09<\/p>\n<p>\u5de5\u4f5c\u7ec4\u91cd\u70b9\u4ecb\u7ecd\u4e86KDIGO 2022\u6162\u6027\u80be\u810f\u75c5\u4f34\u7cd6\u5c3f\u75c5\u7ba1\u7406\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\u7684\u5173\u952e\u63a8\u8350\u548c\u5b9e\u8df5\u8981\u70b9\u3002<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.9.1\uff1a\u9009\u62e9GLP-1 RA\u5e94\u4f18\u5148\u8003\u8651\u5fc3\u8840\u7ba1\u83b7\u76ca3.10\u4ee3\u8c22\u6027\u9178\u4e2d\u6bd2\u5b9e\u8df5\u8981\u70b93.10.1\uff1aCKD\u5e94\u8003\u8651\u836f\u7269\u6cbb\u7597\u8054\u5408\u6216\u4e0d\u8054\u5408\u996e\u98df\u5e72\u9884\uff0c\u9884\u9632\u6709\u6f5c\u5728\u4e34\u5e8a\u610f\u4e49\u7684\u9178\u4e2d\u6bd2\uff08\u5982\u6210\u4eba\u8840\u6e05\u78b3\u9178\u6c22\u76d0&lt;18 mmol\/l\uff09\u5b9e\u8df5\u8981\u70b93.10.2\uff1a\u76d1\u6d4b\u4ee3\u8c22\u6027\u9178\u4e2d\u6bd2\u6cbb\u7597\uff0c\u786e\u4fdd\u8840\u6e05\u78b3\u9178\u6c22\u76d0\u6d53\u5ea6\u4f4e\u4e8e\u6b63\u5e38\u4e0a\u9650\u4ee5\u907f\u514d\u5bf9\u8840\u538b\u63a7\u5236\u3001\u8840\u6e05\u94be\u6216\u4f53\u6db2\u72b6\u6001\u4ea7\u751f\u4e0d\u5229\u5f71\u54cd3.11 CKD\u4f34\u9ad8\u94be\u8840\u75c73.11.1\u8ba4\u8bc6\u94be\u68c0\u6d4b\u7684\u5f71\u54cd\u56e0\u7d20\u5b9e\u8df5\u8981\u70b93.11.1.1\uff1a\u5e94\u6ce8\u610f\u5b9e\u9a8c\u5ba4\u94be\u68c0\u6d4b\u53d8\u5f02\u53ca\u53ef\u80fd\u5f71\u54cd\u94be\u68c0\u6d4b\u7684\u56e0\u7d20\u548c\u673a\u5236\u5982\u663c\u591c\u548c\u5b63\u8282\u6027\u53d8\u5316\u3001\u8840\u6d46\u4e0e\u8840\u6e05\u6837\u672c\u53ca\u836f\u7269\u4f5c\u7528<\/p>\n<p>\u6ce8\uff1a24h\u4f53\u5185K<sup>+<\/sup>\u53d8\u53160.24-0.73 mmol\/l\uff0c\u5927\u591a\u6570\u4eba\u63a5\u8fd1\u4e2d\u5348\u6392\u94be\uff1b\u8840\u6e05\u94be\u901a\u5e38\u9ad8\u4e8e\u8840\u6d46\u94be\uff1bCKD\u60a3\u8005\u591a\u6570\u9910\u540eK<sup>+<\/sup>\u8fc7\u9ad8<\/p>\n<\/p>\n<p>\u666e\u901a\u4eba\u7fa4\u548c\u6162\u6027\u80be\u810f\u75c5\u9ad8\u5371\u4eba\u7fa4\u8840\u94be\u5206\u5e03<\/p>\n<p>3.11.2\u94be\u4ea4\u6362\u5242\u5b9e\u8df5\u8981\u70b93.11.2.1\uff1a\u5e94\u5173\u6ce8\u5f53\u5730\u6216\u533b\u9662\u975e\u7d27\u6025\u9ad8\u94be\u8840\u75c7\u6cbb\u7597\u7684\u836f\u7269\u6216\u5904\u65b9\u9650\u52363.11.3 \u6210\u4eba\u4e2d\u91cd\u5ea6\u9ad8\u94be\u8840\u75c7\u6cbb\u7597\u540e\u8840\u94be\u590d\u67e5\u65f6\u673a\uff08\u65e0\u63a8\u8350\u548c\u5b9e\u8df5\u8981\u70b9\uff093.11.4\u9ad8\u94be\u8840\u75c7\u7ba1\u7406\uff08\u65e0\u63a8\u8350\u548c\u5b9e\u8df5\u8981\u70b9\uff093.11.5\u996e\u98df\u6ce8\u610f\u4e8b\u9879\u5b9e\u8df5\u8981\u70b93.11.5.1\uff1aCKD G3-G5\u548c\u7a81\u53d1\u9ad8\u94be\u8840\u75c7\u5e94\u4e2a\u4f53\u5316\u6cbb\u7597\u5305\u62ec\u996e\u98df\u548c\u836f\u7269\u5e72\u9884\uff0c\u540c\u65f6\u9700\u8003\u8651\u76f8\u5173\u5408\u5e76\u75c7\u548c\u751f\u6d3b\u8d28\u91cf\uff08QoL\uff09\u3002\u5efa\u8bae\u80be\u810f\u8425\u517b\u5b66\u5bb6\u6216\u5df2\u8ba4\u8bc1\u7684\u8425\u517b\u4e13\u4e1a\u4eba\u58eb\u8bc4\u4f30\u548c\u6559\u80b2\u5b9e\u8df5\u8981\u70b93.11.5.2\uff1a\u5efa\u8baeCKD G3-G5\u5b58\u5728\u9ad8\u94be\u8840\u75c7\u75c5\u53f2\u7684\u60a3\u8005\uff0c\u5e94\u9650\u5236\u6444\u5165\u5bcc\u542b\u751f\u7269\u53ef\u5229\u7528\u94be\u98df\u7269\uff08\u5982\u52a0\u5de5\u98df\u54c1\uff09\uff0c\u5e76\u9884\u9632\u9ad8\u94be\u8840\u75c7\u98ce\u9669\u53ef\u80fd\u5f15\u8d77\u7684\u76f8\u5173\u75be\u75c53.12\u8d2b\u8840KDIGO 2012\u6162\u6027\u80be\u810f\u75c5\u8d2b\u8840\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\u5c06\u4e8e2024\u5e74\u66f4\u65b0\u30023.13 CKD-\u77ff\u7269\u8d28\u548c\u9aa8\u4ee3\u8c22\u7d0a\u4e71\uff08CKD-MBD\uff09<\/p>\n<p>\u5de5\u4f5c\u7ec4\u91cd\u70b9\u4ecb\u7ecd\u4e86KDIGO 2017\u6162\u6027\u80be\u810f\u75c5-\u77ff\u7269\u8d28\u548c\u9aa8\u4ee3\u8c22\u7d0a\u4e71\uff08CKD-MBD\uff09\u8bca\u65ad\u3001\u8bc4\u4f30\u3001\u9884\u9632\u548c\u6cbb\u7597\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\u66f4\u65b0\u3002\u8bf7\u53c2\u8003\u5df2\u53d1\u8868\u6307\u5357\u7684\u5177\u4f53\u63a8\u8350\u3001\u9009\u62e9\u3001\u836f\u7269\u6cbb\u7597\u5242\u91cf\u548c\u7814\u7a76\u63a8\u8350\u3002<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.14.1\uff1aCKD\u9996\u6b21\u75db\u98ce\u53d1\u4f5c\u540e\uff0c\u9700\u8003\u8651\u542f\u52a8\u964d\u5c3f\u9178\u6cbb\u7597\uff08\u5c24\u5176\u672a\u53d1\u73b0\u53ef\u907f\u514d\u8bf1\u56e0\u6216\u8840\u6e05\u5c3f\u9178\u6d53\u5ea6&gt;&nbsp;535\u03bcmol\/l [9 mg\/dl]\uff09\u5b9e\u8df5\u8981\u70b93.14.2\uff1aCKD\u4f34\u75c7\u72b6\u6027\u9ad8\u5c3f\u9178\u8840\u75c7\uff0c\u9ec4\u560c\u5464\u6c27\u5316\u9176\u6291\u5236\u5242\u4f18\u4e8e\u4fc3\u5c3f\u9178\u6392\u6cc4\u836f\u7269\u5b9e\u8df5\u8981\u70b93.14.3\uff1aCKD\u4f34\u6025\u6027\u75db\u98ce\u5bf9\u75c7\u6cbb\u7597\uff0c\u5c0f\u5242\u91cf\u79cb\u6c34\u4ed9\u78b1\u6216\u5173\u8282\u5185\/\u53e3\u670d\u7cd6\u76ae\u8d28\u6fc0\u7d20\u4f18\u4e8e\u975e\u753e\u4f53\u6297\u708e\u836f\uff08NSAIDs\uff09\u996e\u98df\u65b9\u6cd5\u5b9e\u8df5\u8981\u70b93.14.4\uff1a\u975e\u836f\u7269\u5e72\u9884\u63aa\u65bd\u53ef\u80fd\u6709\u52a9\u4e8e\u9884\u9632\u75db\u98ce\u5982\u9650\u5236\u9152\u7cbe\u3001\u8089\u7c7b\u548c\u9ad8\u679c\u7cd6\u7389\u7c73\u7cd6\u6d46\u6444\u5165\u91cf<\/p>\n<p>\u6ce8\uff1a\u9ad8\u679c\u7cd6\u7389\u7c73\u7cd6\u6d46\u5e7f\u6cdb\u5b58\u5728\u4e8e\u86cb\u7cd5\u3001\u997c\u5e72\u3001\u679c\u6c41\u3001\u756a\u8304\u9171\u3001\u7f50\u5934\u98df\u54c1\u3001\u5976\u8336\u7b49\u996e\u6599\u548c\u751c\u70b9<\/p>\n<p>3.15\u5fc3\u8840\u7ba1\u75be\u75c5\uff08CVD\uff09\u548c\u964d\u4f4e\u98ce\u9669\u7684\u5177\u4f53\u5e72\u9884\u63aa\u65bd<\/p>\n<p>3.15.1 \u8840\u8102\u7ba1\u7406\u4ed6\u6c40\u7c7b\u836f\u7269\u964d\u4f4e\u4f4e\u5bc6\u5ea6\u8102\u86cb\u767d\u80c6\u56fa\u9187\uff0c\u4f34\u6216\u4e0d\u4f34CKD&nbsp;ASCVD\u98ce\u9669\u83b7\u76ca\u5df2\u8bc1\u5b9e\u3002KDIGO \u6162\u6027\u80be\u810f\u75c5\u8102\u8d28\u7ba1\u7406\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\u5df2\u660e\u786e\u63a8\u8350\u4f55\u65f6\u542f\u52a8\u4ed6\u6c40\u7c7b\u836f\u7269\u6cbb\u7597\uff1a\u5b9e\u8df5\u8981\u70b93.15.1.1\uff1a\u4f7f\u7528\u5df2\u9a8c\u8bc1\u98ce\u9669\u5de5\u5177\u8bc4\u4f3010\u5e74\u5fc3\u8840\u7ba1\u98ce\u9669\u5b9e\u8df5\u8981\u70b93.15.1.2\uff1aCKD\u9009\u62e9\u4ee5\u4ed6\u6c40\u7c7b\u836f\u7269\u4e3a\u57fa\u7840\u7684\u65b9\u6848\uff0c\u53ef\u6700\u5927\u9650\u5ea6\u964d\u4f4e\u4f4e\u5bc6\u5ea6\u8102\u86cb\u767d\uff08LDL\uff09\u80c6\u56fa\u9187\u7edd\u5bf9\u503c\uff0c\u4ee5\u83b7\u5f97\u6700\u5927\u6cbb\u7597\u6548\u679c\u5b9e\u8df5\u8981\u70b93.15.1.3\uff1a18-49\u5c81\u6210\u4ebaCKD\uff0c10\u5e74\u51a0\u5fc3\u75c5\u6b7b\u4ea1\u6216\u975e\u81f4\u6b7b\u6027\u5fc3\u808c\u6897\u6b7b\u53d1\u751f\u7387\u4f30\u8ba1\u8f83\u4f4e\uff08\u5373&lt;10%\uff09\u4e5f\u53ef\u80fd\u662f\u542f\u52a8\u4ed6\u6c40\u7c7b\u836f\u7269\u6cbb\u7597\u7684\u5408\u9002\u9608\u503c\u5b9e\u8df5\u8981\u70b93.15.1.4\uff1a\u5b58\u5728\u9002\u5e94\u75c7\u7684CKD\u53ef\u8003\u8651\u5904\u65b9\u524d\u86cb\u767d\u8f6c\u5316\u9176\u67af\u8349\u6746\u83cc\u86cb\u767d\u9176\/kexin 9\u578b\uff08PCSK-9\uff09\u6291\u5236\u5242\u996e\u98df\u65b9\u6cd5\u5b9e\u8df5\u8981\u70b93.15.1.5\uff1a\u9664\u8c03\u8102\u6cbb\u7597\u5c1a\u53ef\u8003\u8651\u57fa\u4e8e\u690d\u7269\u6027\u7684\u201c\u5730\u4e2d\u6d77\u5f0f\u201d\u996e\u98df\u964d\u4f4e\u5fc3\u8840\u7ba1\u98ce\u9669\u6ce8\uff1a\u5730\u4e2d\u6d77\u5f0f\u996e\u98df\u5f3a\u8c03\u7279\u7ea7\u521d\u69a8\u6a44\u6984\u6cb9\u4e14\u5bcc\u542b\u4e0d\u9971\u548c\u8102\u80aa3.15.2\u6297\u8840\u5c0f\u677f\u6cbb\u7597<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.15.2.1\uff1a\u963f\u53f8\u5339\u6797\u4e0d\u8010\u53d7\u53ef\u8003\u8651\u5176\u4ed6\u6297\u8840\u5c0f\u677f\u6cbb\u7597\uff08\u5982P2Y<sub>12<\/sub>\u6291\u5236\u5242\uff09<\/p>\n<p>3.15.3\u51a0\u72b6\u52a8\u8109\u75be\u75c5\u4fb5\u5165\u6027\u4e0e\u5f3a\u5316\u6027\u836f\u7269\u6cbb\u7597<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.15.3.1\uff1aCKD\u4f34\u6025\u6027\u6216\u4e0d\u7a33\u5b9a\u51a0\u72b6\u52a8\u8109\u75be\u75c5\u3001\u4e0d\u53ef\u8010\u53d7\u5fc3\u7ede\u75db\uff08\u5982\u60a3\u8005\u4e0d\u6ee1\uff09\u3001\u7f3a\u8840\u5bfc\u81f4\u5de6\u5fc3\u5ba4\u6536\u7f29\u529f\u80fd\u969c\u788d\u6216\u5de6\u4e3b\u5e72\u75be\u75c5\uff0c\u521d\u59cb\u6cbb\u7597\u4e3a\u4fb5\u5165\u6027\u7b56\u7565\u53ef\u80fd\u4ecd\u662f\u66f4\u597d\u9009\u62e9<\/p>\n<p>3.16 CKD\u548c\u5fc3\u623f\u98a4\u52a8\u5b9e\u8df5\u8981\u70b93.16.1\uff1a\u9075\u5faa\u623f\u98a4\u8bca\u65ad\u548c\u6cbb\u7597\u7684\u65e2\u5b9a\u7b56\u7565\uff08Figure 40\uff09Figure 40 | \u623f\u98a4\u7684\u8bca\u65ad\u548c\u6cbb\u7597\u7b56\u7565\u3002*\u6162\u6027\u80be\u810f\u75c5\uff08CKD\uff09\u9700\u8c03\u6574\u5242\u91cf\u3002\u2020\u63a8\u8350\u4ee5\u4e0b\u4e3a\u65b0\u53d1\u623f\u98a4\u8bca\u65ad\u8bc4\u4f30\u7684\u6807\u51c6\u65b9\u6848\uff1a(i)12\u5bfc\u8054\u5fc3\u7535\u56fe\uff08ECG\uff09\u786e\u5b9a\u8bca\u65ad\u8bc4\u4f30\u5fc3\u5ba4\u7387\uff0c\u5e76\u68c0\u67e5\u662f\u5426\u5b58\u5728\u4f20\u5bfc\u7f3a\u9677\u3001\u7f3a\u8840\u6216\u7ed3\u6784\u6027\u5fc3\u810f\u75c5\uff1b(ii)\u5b9e\u9a8c\u5ba4\u68c0\u6d4b\u7532\u72b6\u817a\u548c\u80be\u810f\u529f\u80fd\u3001\u8840\u6e05\u7535\u89e3\u8d28\u548c\u5168\u8840\u7ec6\u80de\u8ba1\u6570\uff1b(iii)\u7ecf\u80f8\u8d85\u58f0\u5fc3\u52a8\u56fe\u8bc4\u4f30\u5de6\u5fc3\u5ba4\u5927\u5c0f\u548c\u529f\u80fd\u3001\u5de6\u5fc3\u623f\u5927\u5c0f\u3001\u74e3\u819c\u6027\u75be\u75c5\u548c\u53f3\u5fc3\u5927\u5c0f\u548c\u529f\u80fd\u3002BP \u8840\u538b\uff1bCHA<sub>2<\/sub>DS<sub>2<\/sub>-VASc&nbsp;\u5145\u8840\u6027\u5fc3\u529b\u8870\u7aed\u3001\u9ad8\u8840\u538b\u3001\u5e74\u9f84\u226575\uff08\u53cc\u500d\uff09\u3001\u7cd6\u5c3f\u75c5\u3001\u4e2d\u98ce\uff08\u53cc\u500d\uff09\u3001\u8840\u7ba1\u75be\u75c5\u3001\u5e74\u9f8465-74\u5c81\u53ca\u6027\u522b\uff08\u5973\u6027\uff09\uff1bHAS-BLED&nbsp;\u9ad8\u8840\u538b\u3001\u809d\/\u80be\u529f\u80fd\u5f02\u5e38\u3001\u4e2d\u98ce\u53f2\u3001\u51fa\u8840\u53f2\u6216\u6613\u611f\u4f53\u8d28\u3001\u56fd\u9645\u6807\u51c6\u5316\u6bd4\u503c(INR) \u4e0d\u7a33\u5b9a\u3001\u8001\u5e74\u4eba\u3001\u6bd2\u54c1\/\u9152\u7cbe\u6ee5\u7528<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.16.2\uff1aNOAC\u9700\u4f9d\u636eGFR\u8c03\u6574\u5242\u91cf\uff0cCKD&nbsp;G4-G5\u5e94\u8c28\u614e<\/p>\n<p>\u5b9e\u8df5\u8981\u70b93.16.3\uff1a\u62e9\u671f\u624b\u672f\u524d\u505c\u7528NOAC\u7684\u6301\u7eed\u65f6\u95f4\u9700\u8003\u8651\u624b\u672f\u51fa\u8840\u98ce\u9669\u3001NOAC\u5904\u65b9\u548cGFR\u6c34\u5e73\uff08Figure 44\uff09<\/p>\n<p>Figure 44 |&nbsp;\u672f\u524d\u4f55\u65f6\u505c\u7528\u975e\u7ef4\u751f\u7d20K\u62ee\u6297\u5242\u53e3\u670d\u6297\u51dd\u5242\uff08NOACs\uff09\u5efa\u8bae\uff08\u4f4e\u4e0e\u9ad8\u98ce\u9669\uff09\u3002\u7c97\u4f53\u503c\u90e8\u5206\u4e0e\u5e38\u89c424h\u4f4e\u98ce\u9669\u300148h\u9ad8\u98ce\u9669\u505c\u836f\u89c4\u5219\u6709\u5dee\u5f02\u3002\u4f4e\u98ce\u9669\u4e3a\u51fa\u8840\u9891\u7387\u4f4e\u548c\/\u6216\u51fa\u8840\u5f71\u54cd\u5c0f\u3002\u9ad8\u98ce\u9669\u4e3a\u51fa\u8840\u9891\u7387\u9ad8\u548c\/\u6216\u6709\u91cd\u8981\u4e34\u5e8a\u5f71\u54cd\u3002\u53c2\u8003Heidbuchel H, Verhamme P, Alings M, et al. Updated European Heart Rhythm Association practical guide on the use of non\u2013vitamin-K&nbsp;antagonist anticoagulants in patients with non-valvular atrial fibrillation: executive summary. Eur Heart J. 2017;38:2137\u20132149\u3002\u8bb8\u591a\u4eba\u53ef\u80fd\u53e3\u670d\u8f83\u4f4e\u5242\u91cf\u8fbe\u6bd4\u52a0\u7fa4\uff08110mg bid \uff09\u6216\u963f\u54cc\u6c99\u73ed\uff082.5mg bid\uff09\uff0c\u6216\u5fc5\u987b\u53e3\u670d\u8f83\u4f4e\u5242\u91cf\u5229\u4f10\u6c99\u73ed\uff0815mg QD\uff09\u6216\u827e\u591a\u6c99\u73ed\uff0830mg QD\uff09\u3002\u7f8e\u56fd\u98df\u54c1\u548c\u836f\u7269\u7ba1\u7406\u5c40\u5c1a\u672a\u6279\u51c6\u8fbe\u6bd4\u52a0\u7fa4110mg bid\u3002CrCl&nbsp;\u808c\u9150\u6e05\u9664\u7387\uff1bLMWH&nbsp;\u4f4e\u5206\u5b50\u809d\u7d20\uff1bUFH&nbsp;\u666e\u901a\u809d\u7d20\u3002\u8f6c\u81eaTurakhia MP,&nbsp;Blankestijn PJ, Carrero JJ, et al. Chronic kidney disease and arrhythmias: conclusions from a Kidney Disease: Improving Global Outcomes&nbsp;(KDIGO) Controversies Conference. Eur Heart J. 2018;39:2314\u20132325.710\u3002\u5f00\u653e\u6388\u6743\u3002<\/p>\n<p>\u7b2c4\u7ae0\uff1aCKD\u836f\u7269\u4f7f\u7528\u548c\u7ba1\u7406\u5de5\u4f5c<\/p>\n<p>4.1\u836f\u7269\u9009\u62e9\u548c\u5b89\u5168\u6027\u76d1\u6d4b\u5b9e\u8df5\u8981\u70b94.1.1\uff1a\u836f\u7269\u6bd2\u6027\u53ef\u80fd\u66f4\u5bb9\u6613\u5f71\u54cdCKD\u4eba\u7fa4\uff0c\u5904\u65b9\u836f\u7269\u5e94\u8003\u8651\u83b7\u76ca\u4e0e\u6f5c\u5728\u5371\u5bb3\u5b9e\u8df5\u8981\u70b94.1.2\uff1a\u4e0d\u8bba\u95e8\u8bca\u8fd8\u662f\u533b\u9662\uff0cCKD\u836f\u7269\u6cbb\u7597\u7a97\u53e3\u7a84\u3001\u53ef\u80fd\u5b58\u5728\u4e0d\u826f\u53cd\u5e94\u6216\u80be\u6bd2\u6027\uff0c\u5747\u5e94\u76d1\u6d4beGFR\u3001\u7535\u89e3\u8d28\u548c\u836f\u7269\u6d53\u5ea6\u5b9e\u8df5\u8981\u70b94.1.3\uff1a\u53ef\u80fd\u635f\u5bb3CKD\u7684\u975e\u5904\u65b9\u836f\u548c\u996e\u98df\u6216\u8349\u836f\u5747\u5e94\u5ba1\u67e5\u5e76\u9650\u5236\u836f\u7269\u4e0e\u598a\u5a20\u5b9e\u8df5\u8981\u70b94.1.4\uff1a\u6709\u751f\u80b2\u80fd\u529b\u7684CKD\u4eba\u7fa4\u5904\u65b9\u836f\u7269\uff0c\u5fc5\u987b\u5ba1\u67e5\u836f\u7269\u81f4\u7578\u7684\u53ef\u80fd\uff0c\u5e76\u4f9d\u636eCKD\u4eba\u7fa4\u63d0\u4f9b\u4e2a\u6027\u5316\uff08\u4ef7\u503c\u89c2\u548c\u504f\u597d\uff09\u5b9a\u671f\u751f\u6b96\u548c\u907f\u5b55\u54a8\u8be24.2\u4f9d\u636eGFR\u6c34\u5e73\u8c03\u6574\u836f\u7269\u5242\u91cf\u5b9e\u8df5\u8981\u70b94.2.1\uff1a\u5904\u65b9\u7ecf\u80be\u810f\u6e05\u9664\u7684\u836f\u7269\u9700\u8003\u8651GFR\u5b9e\u8df5\u8981\u70b94.2.2\uff1a\u5df2\u9a8c\u8bc1\u542bSCr&nbsp;eGFR\u65b9\u7a0b\u9002\u5408\u5927\u591a\u6570\u4eba\u548c\u4e34\u5e8a\u60c5\u51b5\u8c03\u6574\u836f\u7269\u5242\u91cf\u5b9e\u8df5\u8981\u70b94.2.3\uff1a\u67d0\u4e9b\u4e34\u5e8a\u60c5\u51b5\u9700\u8981\u7cbe\u786e\u6027\u8f83\u9ad8\uff0c\u5982\u836f\u7269\u76f8\u5173\u51b3\u7b56\uff08\u6cbb\u7597\u7a97\u7a84\u6216\u6bd2\u6027\u836f\u7269\u7ed9\u836f\u5242\u91cf\uff09\u3001\u836f\u7269\u6bd2\u6027\u6216\u4f30\u8ba1eGFRcr\u53ef\u80fd\u4e0d\u53ef\u9760\uff0c\u5e94\u8003\u8651\u808c\u9150\u8054\u5408\u80f1\u6291\u7d20C\u65b9\u7a0b\u6216\u68c0\u6d4bGFR\u5b9e\u8df5\u8981\u70b94.2.4\uff1a\u6781\u7aef\u4f53\u91cd\u4eba\u7fa4\u53ef\u80fd\u9700\u8981\u68c0\u6d4b\u4e0e\u4f53\u8868\u9762\u79ef\uff08BSA\uff09\u65e0\u5173\u7684eGFR\uff0c\u5c24\u5176\u8c03\u6574\u6cbb\u7597\u8303\u56f4\u8f83\u7a84\u6216\u9700\u6700\u4f4e\u6709\u6548\u6d53\u5ea6\u7684\u836f\u7269\u5b9e\u8df5\u8981\u70b94.2.5\uff1aGFR\u3001\u6ee4\u8fc7\u6807\u5fd7\u7269\u975eGFR\u51b3\u5b9a\u56e0\u7d20\u6216\u5206\u5e03\u5bb9\u79ef\u4e0d\u7a33\u5b9a\u4eba\u7fa4\u5e94\u8003\u8651\u8c03\u6574\u836f\u7269\u5242\u91cf4.3\u591a\u91cd\u7528\u836f\u548c\u836f\u7269\u7ba1\u7406\u5de5\u4f5c\u5b9e\u8df5\u8981\u70b94.3.1\uff1a\u5b9a\u671f\u5f7b\u5e95\u68c0\u67e5\u836f\u7269\uff0c\u4e14\u4e8e\u7ba1\u7406\u8fc7\u6e21\u671f\u95f4\u8bc4\u4f30\u4f9d\u4ece\u6027\u3001\u6301\u7eed\u6027\u9002\u5e94\u75c7\u548c\u6f5c\u5728\u7684\u836f\u7269\u76f8\u4e92\u4f5c\u7528\uff08CKD\u836f\u7269\u6cbb\u7597\u65b9\u6848\u901a\u5e38\u590d\u6742\u4e14\u5c31\u8bca\u4e8e\u591a\u4f4d\u4e13\u5bb6\uff09\u5b9e\u8df5\u8981\u70b94.3.2\uff1a\u5982\u679c\u6025\u6027\u75be\u75c5\u671f\u95f4\u9700\u505c\u836f\uff0c\u5e94\u5411\u60a3\u8005\u548c\u5176\u4ed6\u533b\u52a1\u4eba\u5458\u660e\u786e\u4f55\u65f6\u91cd\u65b0\u542f\u52a8\u7528\u836f\u8ba1\u5212\u5e76\u786e\u4fdd\u8bb0\u5f55\u4e8e\u533b\u7597\u6587\u4e66\u5b9e\u8df5\u8981\u70b94.3.3\uff1a\u62e9\u671f\u624b\u672f\u524d48-72h\u5185\u6216\u4e0d\u826f\u53cd\u5e94\u7d27\u6025\u5904\u7406\u671f\u95f4\u53ef\u80fd\u8ba1\u5212\u505c\u836f\uff08\u5982\u4e8c\u7532\u53cc\u80cd\u3001ACEi\u3001ARB\u548cSGLT2i\uff09\u4ee5\u9884\u9632\u5e76\u53d1\u75c7\u3002\u4f46\u5e94\u5173\u6ce8\u4e8b\u4ef6\u6216\u672f\u540e\u4e0d\u80fd\u91cd\u65b0\u542f\u52a8\u505c\u6b62\u836f\u7269\u53ef\u80fd\u5bfc\u81f4\u7684\u610f\u5916\u4f24\u5bb3\uff08\u53c2\u89c1\u5b9e\u8df5\u70b9 4.3.2\uff094.3.1\u63d0\u5347\u836f\u54c1\u7ba1\u7406\u5de5\u4f5c\u7b56\u7565\u5b9e\u8df5\u8981\u70b94.3.1.1\uff1a\u6559\u80b2\u548c\u544a\u77e5CKD\u60a3\u8005\u836f\u7269\u7684\u9884\u671f\u83b7\u76ca\u548c\u53ef\u80fd\u98ce\u9669\uff0c\u4ee5\u4fbf\u60a3\u8005\u80fd\u8bc6\u522b\u548c\u62a5\u544a\u53ef\u63a7\u5236\u7684\u4e0d\u826f\u4e8b\u4ef6\u5b9e\u8df5\u8981\u70b94.3.1.2\uff1a\u4e0e\u5176\u4ed6\u533b\u52a1\u5de5\u4f5c\u8005\u548c\u836f\u5242\u5e08\u5efa\u7acb\u5408\u4f5c\u5173\u7cfb\u548c\/\u6216\u4f7f\u7528\u5de5\u5177\u786e\u4fdd\u548c\u6539\u5584CKD\u60a3\u8005\u7684\u836f\u7269\u7ba1\u7406\uff0c\u4ee5\u52a0\u5f3a\u590d\u6742\u836f\u7269\u6cbb\u7597\u65b9\u6848\u7684\u7ba1\u74064.4\u5f71\u50cf\u5b66\u68c0\u67e5\u5b9e\u8df5\u8981\u70b94.4.1\uff1aCKD\u5f71\u50cf\u5b66\u68c0\u67e5\u9002\u5e94\u75c7\u7c7b\u4f3c\u666e\u901a\u4eba\u7fa4\u3002\u5f71\u50cf\u5b66\u68c0\u67e5\u7684\u98ce\u9669\u548c\u83b7\u76ca\u5e94\u4f9d\u636eCKD\u4eba\u7fa4\u4e2a\u4f53\u5316\u9009\u62e94.4.1\u653e\u5c04\u6027\u5bf9\u6bd4\uff1a\u52a8\u8109\u5185\u548c\u9759\u8109\u5185\u5bf9\u6bd4\u5242\u68c0\u67e5\u5b9e\u8df5\u8981\u70b94.4.1.1\uff1a\u5fc3\u810f\u624b\u672fCKD\u60a3\u8005\u5e94\u4f7f\u7528\u5df2\u9a8c\u8bc1\u5de5\u5177\u8bc4\u4f30\u52a8\u8109\u5185\u5bf9\u6bd4\u5242\u53d1\u751fAKI\u7684\u98ce\u9669\u5b9e\u8df5\u8981\u70b94.4.1.2\uff1aAKI\u6216GFR &lt;60 ml\/min\/1.73 m<sup>2<\/sup>\uff08CKD G3a\u2013G5\uff09\u62df\u9009\u62e9\u5bf9\u6bd4\u5242\u68c0\u67e5\uff0c\u9759\u8109\u6ce8\u5c04\u653e\u5c04\u6027\u5bf9\u6bd4\u5242\u53ef\u4f9d\u636e\u653e\u5c04\u5b66\u4f1a\u5171\u8bc6\u58f0\u7ba1\u74064.4.2\u542b\u9486\u9020\u5f71\u5242<\/p>\n<p>\u5b9e\u8df5\u8981\u70b94.4.2.1\uff1aGFR &lt;30 ml\/min\/1.73 m<sup>2<\/sup>\uff08CKD G4\u2013G5\uff09\u9700\u542b\u9486\u9020\u5f71\u5242\u8005\uff0c\u4f18\u5148\u4f7f\u7528\u7f8e\u56fd\u653e\u5c04\u5b66\u4f1a\uff08ACR\uff09II\u7ec4\u548cIII\u7ec4\u9486\u57fa\u5bf9\u6bd4\u5242\uff08GBCM\uff09<\/p>\n<p>\u7b2c5\u7ae0\uff1a\u6700\u4f73\u7ba1\u7406\u6a21\u5f0f<\/p>\n<p>5.1 \u8f6c\u8bca\u81f3\u80be\u810f\u4e13\u4e1a\u7ba1\u7406\u5b9e\u8df5\u8981\u70b95.1.1\uff1a\u82e5\u53d1\u751fFigure 48\u5217\u51fa\u60c5\u51b5\uff0c\u5e94\u5c06CKD\u6210\u4eba\u8f6c\u8bca\u81f3\u80be\u810f\u4e13\u4e1a\u673a\u6784\u7ba1\u7406Figure48 | \u8f6c\u8bca\u81f3\u80be\u810f\u4e13\u4e1a\u673a\u6784\u7ba1\u7406\u7684\u60c5\u51b5\u53ca\u76ee\u7684\u3002ACR\u767d\u86cb\u767d-\u808c\u9150\u6bd4\u503c\uff1bAER\u767d\u86cb\u767d\u6392\u6cc4\u7387\uff1bCKD\u6162\u6027\u80be\u810f\u75c5\uff1beGFR\u4f30\u8ba1\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\uff1bKRT&nbsp;\u80be\u810f\u66ff\u4ee3\u6cbb\u7597\uff1bPCR\u86cb\u767d\u808c\u9150\u6bd4\u503c\uff1bPER\u86cb\u767d\u6392\u6cc4\u7387\uff1bRBC\u7ea2\u7ec6\u80de\u7279\u6b8a\u60c5\u51b5\u513f\u7ae5\u6ce8\u610f\u4e8b\u9879\u5b9e\u8df5\u8981\u70b95.1.2\uff1a\u4e0b\u5217\u60c5\u51b5\uff0c\u513f\u7ae5\u53ca\u9752\u5c11\u5e74\u5e94\u8f6c\u8bca\u81f3\u80be\u810f\u4e13\u4e1a\u673a\u6784\u7ba1\u7406\uff1a<\/p>\n<ul>\n<li>\u7ecf\u91cd\u590d\u521d\u6b21\u6668\u5c3f\u6837\u672c\u786e\u8ba4\uff08\u4e00\u822c\u8eab\u4f53\u72b6\u51b5\u826f\u597d\u4e14\u975e\u6708\u7ecf\u671f\uff09\uff0cACR\u226530mg\/g\uff083mg\/mmol\uff09\u6216PCR\u2265200&nbsp;mg\/g\uff0820&nbsp;mg\/mmol\uff09<\/li>\n<li>\u6301\u7eed\u6027\u8840\u5c3f<\/li>\n<li>eGFR\u6301\u7eed\u4e0b\u964d<\/li>\n<li>\u9ad8\u8840\u538b<\/li>\n<li>\u80be\u810f\u6d41\u51fa\u9053\u6897\u963b\u6216\u80be\u810f\u548c\u5c3f\u8def\u5f02\u5e38<\/li>\n<li>\u5df2\u77e5\u6216\u7591\u4f3cCKD\u6216<\/li>\n<li>\u53cd\u590d\u5c3f\u8def\u611f\u67d3<\/li>\n<\/ul>\n<p>5.2 CKD\u75c7\u72b6<\/p>\n<p>5.2.1 CKD\u75c7\u72b6\u60a3\u75c5\u7387\u548c\u4e25\u91cd\u7a0b\u5ea6<\/p>\n<p>\uff08\u65e0\u63a8\u8350\u548c\u5b9e\u8df5\u8981\u70b9\uff09<\/p>\n<p>5.2.2 \u8bc6\u522b\u548c\u8bc4\u4f30\u75c7\u72b6<\/p>\n<p>\u5b9e\u8df5\u8981\u70b95.2.2.1\uff1a\u8fdb\u5c55\u6027CKD\u6bcf\u6b21\u5c31\u8bca\u6216\u968f\u8bbf\uff0c\u5e94\u4f7f\u7528\u6807\u51c6\u5316\u5c3f\u6bd2\u75c7\u75c7\u72b6\u8bc4\u4f30\u5de5\u5177\u7b5b\u67e5\u5c3f\u6bd2\u75c7\u75c7\u72b6\uff08\u5982\u98df\u6b32\u51cf\u9000\u3001\u6076\u5fc3\u548c\u75b2\u52b3\/\u55dc\u7761\u7a0b\u5ea6\uff09<\/p>\n<p>5.2.3CKD\u4eba\u7fa4\u5e38\u89c1\u75c7\u72b6\u5904\u7406<\/p>\n<p>\u5b9e\u8df5\u8981\u70b95.2.3.1\uff1a\u4ee5\u5faa\u8bc1\u7ba1\u7406\u7b56\u7565\u652f\u6301CKD\u60a3\u8005\u826f\u597d\u751f\u6d3b\u5e76\u6539\u5584\u5065\u5eb7\u76f8\u5173\u751f\u6d3b\u8d28\u91cf<\/p>\n<p>\u5b9e\u8df5\u8981\u70b95.2.3.2\uff1aCKD G4-G5\u3001\u5e74\u9f84&gt;65\u5c81\u3001\u751f\u957f\u4e0d\u826f\uff08\u513f\u7ae5\uff09\u6216\u975e\u81ea\u613f\u4f53\u91cd\u51cf\u8f7b\u3001\u865a\u5f31\u6216\u98df\u6b32\u4e0d\u632f\u7b49\u5e94\u6bcf\u5e74\u4f7f\u7528\u5df2\u9a8c\u8bc1\u8bc4\u4f30\u5de5\u5177\u7b5b\u67e5\u8425\u517b\u4e0d\u826f\u4e24\u6b21<\/p>\n<p>\u5b9e\u8df5\u8981\u70b95.2.3.3\uff1a\u5b58\u5728\u8425\u517b\u4e0d\u826f\u75c7\u72b6\u7684\u60a3\u8005\u5e94\u5728\u80be\u810f\u8425\u517b\u5e08\u6216\u5df2\u8ba4\u8bc1\u8425\u517b\u4e13\u4e1a\u4eba\u58eb\u76d1\u7763\u4e0b\uff0c\u8fdb\u884c\u9002\u5f53\u7684\u533b\u7597\u8425\u517b\u6cbb\u7597<\/p>\n<p>5.3 \u57fa\u4e8e\u56e2\u961f\u7684\u7efc\u5408\u7ba1\u7406<\/p>\n<p>\u5b9e\u8df5\u8981\u70b95.3.1\uff1a\u5efa\u7acb\u4ee5\u60a3\u8005\u4e3a\u4e2d\u5fc3\u7684\u591a\u5b66\u79d1\u7ba1\u7406\u56e2\u961f\uff0c\u5305\u62ec\u996e\u98df\u54a8\u8be2\u3001\u836f\u7269\u7ba1\u7406\u3001\u6559\u80b2\u548c\u4e0d\u540c\u65b9\u5f0fKRT\u54a8\u8be2\u3001\u79fb\u690d\u9009\u62e9\u3001\u900f\u6790\uff08\u901a\u8def\uff09\u624b\u672f\u53caCKD\u60a3\u8005\u9053\u5fb7\u3001\u5fc3\u7406\u548c\u793e\u4f1a\u5173\u6000<\/p>\n<p>\u5b9e\u8df5\u8981\u70b95.3.2\uff1a\u6559\u80b2\u8ba1\u5212\u8fd8\u5e94\u6d89\u53ca\u7ba1\u7406\u5408\u4f5c\u4f19\u4f34\u2014\u2014\u4fc3\u8fdbCKD\u60a3\u8005\u77e5\u60c5\u3001\u79ef\u6781\u4e3b\u52a8\u975e\u5e38\u91cd\u8981<\/p>\n<p>\u5b9e\u8df5\u8981\u70b95.3.3\uff1a\u53ef\u8003\u8651\u8fdc\u7a0b\u533b\u7597\u6280\u672f\u6559\u80b2\u548c\u7ba1\u7406CKD\u60a3\u8005\uff0c\u5305\u62ec\u7f51\u7edc\u3001\u79fb\u52a8\u5e94\u7528\u7a0b\u5e8f\uff08APP\uff09\u3001\u865a\u62df\uff08\u673a\u5668\u4eba\uff09\u968f\u8bbf\u548c\u53ef\u7a7f\u6234\u8bbe\u5907<\/p>\n<p>\u7279\u6b8a\u60c5\u51b5<\/p>\n<p>\u513f\u7ae5\u6ce8\u610f\u4e8b\u9879<\/p>\n<p>5.3.1 \u513f\u7ae5CKD\u8f6c\u8bca\u6210\u4eba\u7ba1\u7406<\/p>\n<p>5.3.1.1\u513f\u7ae5\u533b\u52a1\u5de5\u4f5c\u8005\u5b9e\u8df5\u8981\u70b95.3.1.1.1\uff1a11-14\u5c81\u5f00\u59cb\uff0c\u4f7f\u7528\u68c0\u67e5\u8868\u8bc4\u4f30\u51c6\u5907\u60c5\u51b5\u5e76\u6307\u5bfc\u51c6\u5907\u5de5\u4f5c\uff1b\u6bcf\u6b21\u968f\u8bbf\u5e94\u6709\u7236\u6bcd\/\u76d1\u62a4\u4eba\u4e0d\u5728\u573a\u7684\u4ea4\u6d41\u65f6\u95f4\uff0c\u4e3a\u9752\u5c11\u5e74\u53ca\u5bb6\u4eba\u8f6c\u8bca\u81f3\u6210\u4ebaCKD\u7ba1\u7406\u505a\u597d\u51c6\u5907\uff08Figure&nbsp;55\uff09<\/p>\n<p>Figure 55 | \u6162\u6027\u80be\u810f\u75c5\uff08CKD\uff09\u513f\u7ae5\u7ba1\u7406\u8f6c\u8bca\u81f3\u6210\u4eba\u8fc7\u6e21\u6d41\u7a0b\u5b9e\u8df5\u8981\u70b95.3.1.1.2\uff1a\u5411\u6210\u4ebaCKD\u7ba1\u7406\u76f8\u5173\u533b\u52a1\u4eba\u5458\u7efc\u5408\u4e66\u9762\u8f6c\u8bca\u4ea4\u63a5\uff0c\u6700\u597d\u540c\u65f6\u53e3\u5934\u4ea4\u63a5\u6240\u6709\u76f8\u5173\u533b\u7597\u8d44\u6599\u53ca\u513f\u7ae5\/\u9752\u5c11\u5e74\u8ba4\u77e5\u80fd\u529b\u548c\u793e\u4f1a\u652f\u6301\u60c5\u51b5\uff08Figure 55\uff09\u5b9e\u8df5\u8981\u70b95.3.1.1.3\uff1a\u5c3d\u53ef\u80fd\u4e8e\u533b\u7597\u72b6\u6001\u548c\u793e\u4f1a\u76f8\u5173\u95ee\u9898\u7a33\u5b9a\u7684\u60c5\u51b5\u4e0b\uff0c\u5c06\u513f\u7ae5\/\u9752\u5c11\u5e74\u8f6c\u8bca\u81f3\u6210\u4ebaCKD\u7ba1\u7406\u673a\u67845.3.1.2 \u6210\u4ebaCKD\u7ba1\u7406\u533b\u52a1\u4eba\u5458\u5b9e\u8df5\u8981\u70b95.3.1.2.1\uff1a\u9700\u8981\u8ba4\u8bc6\u523025\u5c81\u4ee5\u4e0bCKD\u5e74\u8f7b\u4eba\u662f\u72ec\u7279\u7684\u9ad8\u98ce\u9669\u4eba\u7fa4\uff0c\u81f3\u5c11\u90e8\u5206\u539f\u56e0\u6e90\u4e8e\u751f\u7406\u6027\u5927\u8111\u4e0d\u5b8c\u5168\u6210\u719f\u5b9e\u8df5\u8981\u70b95.3.1.2.2\uff1a\u9f13\u52b1\u513f\u7ae5\/\u9752\u5c11\u5e74\u521d\u6b21\u9884\u7ea6\u968f\u8bca\u524d\uff0c\u975e\u6b63\u5f0f\u53c2\u89c2\u6210\u4ebaCKD\u7ba1\u7406\u673a\u6784\uff08Figure 55\uff09\u5b9e\u8df5\u8981\u70b95.3.1.2.3\uff1a\u8bc4\u4f30CKD\u5e74\u8f7b\u4eba\uff08\u513f\u7ae5\/\u9752\u5c11\u5e74\uff09\u5e94\u6bd4\u540c\u671fCKD\u8001\u5e74\u4eba\u66f4\u9891\u7e41\u3002\u5f81\u5f97\u5e74\u8f7b\u4eba\u540c\u610f\u540e\uff0c\u513f\u7ae5CKD\u7ba1\u7406\u8f6c\u8bca\u81f3\u6210\u4eba\u540e\u81f3\u5c111-3\u5e74\u5185\uff0c\u9700\u5c06\u5bb6\u4eba\/\u76d1\u62a4\u4eba\u6216\u5176\u4ed6\u76f8\u5173\u91cd\u8981\u4eba\u5458\u7eb3\u5165\u8bc4\u4f30\u4eba\u7fa4\uff08Figure 55\uff095.4\u542f\u52a8\u900f\u6790\u65f6\u673a\u5b9e\u8df5\u8981\u70b95.4.1\uff1a\u542f\u52a8\u900f\u6790\u5e94\u4f9d\u636eCKD\u60a3\u8005\u7684\u75c7\u72b6\u3001\u4f53\u5f81\u3001\u751f\u6d3b\u8d28\u91cf\u3001\u504f\u597d\u3001GFR\u6c34\u5e73\u548c\u5b9e\u9a8c\u5ba4\u5f02\u5e38\u60c5\u51b5\u7efc\u5408\u8bc4\u4f30\u5b9e\u8df5\u8981\u70b95.4.2\uff1a\u82e5\u53d1\u751f\u4ee5\u4e0b\u4e00\u79cd\u6216\u591a\u79cd\u60c5\u51b5\uff0c\u5219\u542f\u52a8\u900f\u6790\uff08Table 41\uff09\u3002\uff08Table 41\uff09\u4e2d\u60c5\u51b5\u5e38\u53d1\u751f\uff0c\u4f46\u5e76\u975e\u603b\u662f\u53d1\u751f\u4e8eGFR&nbsp;5-10ml \/min \/1.73 m<sup>2<\/sup><\/p>\n<p>Table&nbsp;41 |&nbsp;\u542f\u52a8\u900f\u6790\u9002\u5e94\u75c7<\/p>\n<p>\u5b9e\u8df5\u8981\u70b95.4.3\uff1a\u6210\u4ebaGFR &lt;15-20ml\/min\/1.73 m<sup>2<\/sup>\u62162\u5e74\u5185KRT\u98ce\u9669&gt;40%\uff0c\u5e94\u8003\u8651\u63d0\u524d\u8ba1\u5212\u80be\u79fb\u690d\u548c\/\u6216\u900f\u6790\u901a\u8def\u51c6\u5907\u7279\u6b8a\u60c5\u51b5\u513f\u7ae5\u6ce8\u610f\u4e8b\u9879\u5b9e\u8df5\u8981\u70b95.4.4\uff1a\u513f\u7ae5\u9664\u4e86\u6210\u4eba\u900f\u6790\u6307\u5f81\u5916\uff0c\u4f18\u5316\u8425\u517b\u3001\u7ed9\u4e88\u751f\u957f\u6fc0\u7d20\u548c\u533b\u7597\u7ba1\u7406\u65e0\u6548\u7684\u751f\u957f\u53d1\u80b2\u4e0d\u826f\u4e5f\u5e94\u542f\u52a8KRT\u5b9e\u8df5\u8981\u70b95.4.5\uff1a\u8fdb\u5c55\u6027\u548c\u4e0d\u53ef\u9006\u513f\u7ae5CKD\uff0c\u5e94\u5c06\u6d3b\u4f53\u6216\u5c38\u4f53\u4f9b\u80be\u63d0\u524d\u80be\u79fb\u690d\u4f5c\u4e3a\u6cbb\u7597\u9009\u62e9\u3002\u63d0\u524d\u79fb\u690d\u7684eGFR\u53d6\u51b3\u4e8e\u591a\u79cd\u56e0\u7d20\uff0c\u5305\u62ec\u513f\u7ae5\u7684\u5e74\u9f84\u548c\u5f62\u4f53\u5927\u5c0f\u53ca\u80be\u8870\u7aed\u8fdb\u5c55\u901f\u5ea6\uff0c\u4f46\u901a\u5e38\u4e3a5-15 ml\/min \/1.73 m<sup>2<\/sup>5.5\u652f\u6301\u6cbb\u7597\u548c\u7efc\u5408\u4fdd\u5b88\u7ba1\u7406\u7684\u7ed3\u6784\u4e0e\u6d41\u7a0b\u5b9e\u8df5\u8981\u70b95.5.1\uff1a\u544a\u77e5CKD\u60a3\u8005KRT\u548c\u7efc\u5408\u4fdd\u5b88\u6cbb\u7597\u7684\u9009\u62e9\u5b9e\u8df5\u8981\u70b95.5.2\uff1a\u652f\u6301\u7efc\u5408\u4fdd\u5b88\u7ba1\u7406\uff0c\u5e94\u4f5c\u4e3a\u4e0d\u8ffd\u6c42KRT\u7684\u9009\u62e9\u5b9e\u8df5\u8981\u70b95.5.3\uff1a\u63d0\u4f9b\u793e\u4f1a\u548c\u533b\u7597\u8d44\u6e90\uff0c\u4e3a\u516c\u8ba4\u9700\u8981\u4e34\u7ec8\u62a4\u7406\u8005\uff08\u5305\u62ec\u5df2\u7efc\u5408\u4fdd\u5b88\u7ba1\u7406\u8005\uff09\u63d0\u4f9b\u9ad8\u7ea7\u7ba1\u7406\u8ba1\u5212<\/p>\n<p>\u53c2\u8003\u6587\u732e\uff08\u7565\uff09<\/p>\n<p>\u7f16\u8f91|\u80e1\u5b89\u6f9c&nbsp; &nbsp; &nbsp;\u5ba1\u6838|\u4e8e\u5c0f\u52c7&nbsp;<\/p>\n<p>\u56fd\u5bb6\u4e2d\u533b\u80be\u75c5\uff08\u897f\u5317\uff09\u533a\u57df\u8bca\u7597\u4e2d\u5fc3<\/p>\n","protected":false},"excerpt":{"rendered":"<p>2024 KDIGO 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