蛋白尿作为慢性肾脏疾病的靶点

写的:

Elevated levels of protein in your urine – known as ‘albuminuria’ or ‘proteinuria’ – are associated with an increased risk of 肾脏 function loss over time, 导致慢性肾病(CKD). Clinical research has demonstrated that the level of proteinuria reduction positively correlates with long-term renal protection; so the larger the initial reduction in proteinuria in the first few months of treatment, 治疗期间终末期肾脏疾病的风险越低.¹ However a number of patients carry residual proteinuria although on current standard of care, 仍有肾脏疾病进展的危险.
 

The leakage of even small amounts of protein in the urine is one of the earliest signs of 肾脏 damage and is a predictor for progressive organ function decline. There is also emerging evidence that proteinuria has a toxic effect on renal tissues, 进一步推动肾功能的进行性丧失.¹ Proteinuria is measured via a urine ACR (albumin-to-creatinine ratio) test; a normal amount of urine albumin is less than 30 mg/g and anything above 30 mg/g may indicate you have 肾脏 disease.²

慢性肾脏疾病(CKD)影响着全球十分之一的人，³ and people living with CKD progressively lose 肾脏 function, which can lead to 肾脏 failure. 在现实中, CKD is an umbrella term for many diseases and encompasses various primary disorders and stages of progression. Therefore, patient populations are highly heterogeneous, and treatment can be complex.

肾脏通过清除废物在人体生理中起着至关重要的作用, 平衡体液, 盐和矿物质, 并确保身体许多器官系统处于最佳状态. The 肾脏s accomplish this through complex interplay with other organs like the heart. 不足为奇的是, up to one in five patients diagnosed with 肾脏 disease develop cardiovascular complications, 两者都有共同的风险因素，比如糖尿病, 肥胖和高血压.

尽管有今天的护理标准，仍然存在未满足的需求

Current treatments for CKD include those that interact in the renin-angiotensin-aldosterone system (RAAS) to help regulate blood volume, 电解质平衡和全身血管阻力. Clinical studies have shown that with these treatments there is an initial reduction in proteinuria which positively correlates with the reduction in risk for renal disease progression. However these treatments can be underused because they risk increasing potassium in the blood, 被称为高钾血症.⁴ 除了, research presented at European Renal Association (ERA) Annual Congress shows that people with more advanced 肾脏 disease, 从他们的蛋白尿水平可以看出, 是否更容易患高钾血症.⁵ As 肾脏 function declines, the 肾脏s are less able to remove potassium from blood.⁶ Hyperkalaemia is a common complication in CKD, affecting up to 40-50% of patients.⁷ 它与心血管事件和死亡风险增加有关.^8-10

These challenges may limit current treatment options for patients with poor 肾脏 function and significant proteinuria. There is a need reduce for future treatments to reduce proteinuria whilst managing the risks of hyperkalaemia to slow disease progression.

为蛋白尿患者的识别提供了一个步骤的改变

Currently, despite compelling data, only a minority of patients are screened for high proteinuria. Proteinuria is assessed by measuring the albumin creatinine ratio (ACR) in a patient’s urine and, 即使在同一个人身上，结果也可能不同, 这使得识别有意义的生物变化变得更加困难 以及越来越复杂的临床试验.

In research presented at ERA Annual Congress 2023 we presented a new diagnostic approach to identify patients with proteinuria using machine learning to predict ACR levels from Electronic Health Records.¹¹ The model may in the future support identifying undiagnosed proteinuria and be applied in pre-screening for clinical trials. 澳门第一赌城在线娱乐打算在即将到来的CKD试验中进一步验证该模型. Further 发展 of the technique may lead to a future where we can predict progression of 肾脏 disease without needing to take a urine test at all.

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