口服碳酸氢钠对慢性肾病进程的影响-中国现代应用药学.PDF

口服碳酸氢钠对慢性肾病进程的影响 1 2 刘进 ，梅丽凡 (1.泸州医学院附属医院肾内科，四川 泸州 646000 ；2.南方医科大学附属中山市博爱医院肾内科，广东 中山 528403) 摘要：目的 探讨口服碳酸氢钠能否延缓慢性肾病(chronic kidney disease ，CKD) 肾功能下降的速率。方法 110 例CKD 患者随机分为碳酸氢钠组或安慰剂组，分别口服碳酸氢钠或安慰剂治疗2 年，估算治疗前后肾小球滤过率(eGFR)下降的 1 2 1 1 2 速率，eGFR 快速下降[3 mL·min ·(1.73 m) ·y ]和发展成终末期肾病(ESRD) 患者人数[eGFR10 mL·min ·(1.73 m) ] 比。 同时测量血清白蛋白和饮食蛋白摄入。结果 治疗2 年后，与安慰剂组相比，碳酸氢钠组eGFR 下降较慢(P0.05) ，快速 进展的患者少(P0.05) ，发展成ESRD 的患者也少(P0.05) 。碳酸氢钠组营养参数明显改善。结论 碳酸氢钠可延缓CKD 发展成ESRD 的速率，且可改善CKD 患者的营养状态。 关键词：代谢性酸中毒；慢性肾病；碳酸氢钠；肾小球滤过率；蛋白尿；血压 中图分类号：R969.4 文献标志码：B 文章编号：1007-7693(2012)02-0178-04 Effect of Oral Sodium Bicarbonate on Progression of Chronic Kidney Disease 1 2 LIU Jin , MEI Lifan (1.Department of Renal, the Appendix Hospital of Luzhou Medical College, Luzhou 646000, China; 2.Department of Renal, Boai Hospital of Zhongshan City, Southern Medical University, Zhongshan 528403, China) ABSTRACT: OBJECTIVE To study whether orally administrated sodium bicarbonate slows the decline of renal function in chronic kidney disease (CKD). METHODS All of 110 patients with CKD were randomly divided into sodium bicarbonate group and placebo group, and received the treatment with sodium bicarbonate or placebo for 2 years. Decline rate of glomerular 1 2 1 filtration rate (eGFR), the ratio of patients with rapid decline of eGFR[3 mL·min ·(1.73 m) ·y ] developed to end stag renal disease(ESRD) [eGFR10 mL·min1 2 ·(1.73 m) ] were estimated before and after the treatment. Serum albumin and dielary protein intake were measured at the same time. RE