cystatin

胱抑素
  • 文章类型: Practice Guideline
    慢性肾脏病(CKD)导致大量的全球发病率,并增加心血管和全因死亡率。与其他具有既定筛查策略的慢性病不同,对于卫生系统和政府是否应优先考虑CKD的早期识别和干预,尚无共识。关于评估和管理早期CKD的指南是可用的,但由于缺乏激励措施或质量措施来优先考虑CKD护理,因此尚未普遍采用。CKD的负担不成比例地落在社会经济地位较低的人身上,CKD患病率较高的人,获得治疗的机会有限,和较差的结果。因此,在早期阶段识别和治疗CKD是公平的必要条件。2019年,肾脏病:改善全球结果(KDIGO)举行了一场有争议的会议,题为“CKD的早期识别和干预”。“参与者确定了筛查策略,风险分层,以及早期CKD的治疗以及实施这些过程的关键卫生系统和经济因素。已形成共识,即对高危人群应立即实施CKD筛查以及风险分层和治疗,并且理想情况下,应在初级或社区护理环境中进行,并根据当地情况进行调整。
    Chronic kidney disease (CKD) causes substantial global morbidity and increases cardiovascular and all-cause mortality. Unlike other chronic diseases with established strategies for screening, there has been no consensus on whether health systems and governments should prioritize early identification and intervention for CKD. Guidelines on evaluating and managing early CKD are available but have not been universally adopted in the absence of incentives or quality measures for prioritizing CKD care. The burden of CKD falls disproportionately upon persons with lower socioeconomic status, who have a higher prevalence of CKD, limited access to treatment, and poorer outcomes. Therefore, identifying and treating CKD at the earliest stages is an equity imperative. In 2019, Kidney Disease: Improving Global Outcomes (KDIGO) held a controversies conference entitled \"Early Identification and Intervention in CKD.\" Participants identified strategies for screening, risk stratification, and treatment for early CKD and the key health system and economic factors for implementing these processes. A consensus emerged that CKD screening coupled with risk stratification and treatment should be implemented immediately for high-risk persons and that this should ideally occur in primary or community care settings with tailoring to the local context.
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