Ntau tshaj 20 xyoo dhau los, peb tau sau ib qho tshuaj ntsuam xyuas seb puas los yog tsis yog angiotensin-hloov enzyme inhibitor (ACE)-txuas ntxiv hauv cov ntshav creatinine muaj kev txhawj xeeb tom qab pib ntawm cov tshuaj no [1]. Cov txiaj ntsig zoo ntawm renin-angiotensin system (RAS) blockers, ACE inhibitors, thiab angiotensin receptor blockers (ARBs) tau paub txog yuav luag 30 xyoo. Cov tshuaj no ua rau kwv yees li 10-30 feem pua ​​​​thaum pib txo qis hauv kwv yees glomerular filtration (eGFR) thaum pib kho [1, 2]. Qhov pib poob hauv eGFR no yuav txawv nyob ntawm seb muaj dej txaus thiab lub sijhawm tswj ntshav siab tsis zoo. Nws kuj tseem paub zoo tias cov tshuaj no txo ​​cov ntshav siab thiab albuminuria thiab ua rau qeeb ntawm cov kab mob raum hauv cov neeg uas muaj thiab tsis muaj ntshav qab zib [3].

Raws li cov kev tshawb fawb muaj feem xyuam, cistanche yog ib txwm suav tshuaj ntsuab uas tau siv rau ntau pua xyoo los kho ntau yam kab mob. Nws tau raug tshawb fawb pov thawj kom muajanti-inflammatory, anti-aging, thiabantioxidant zog. Cov kev tshawb fawb tau pom tias cistanche muaj txiaj ntsig zoo rau cov neeg mob uas raug mobraumkab mob. Cov khoom xyaw nquag ntawm cistanche paub txogtxo qhov mob, txhim khoraummuaj nuj nqithiabrestore lub raum puas hlwb. Yog li, kev sib koom ua ke cistanche hauv txoj kev npaj kho mob raum tuaj yeem muab txiaj ntsig zoo rau cov neeg mob hauv kev tswj hwm lawv tus mob.Cistanchepab txo qis proteinuria, txo qis BUN thiab creatinine qib, thiab txo qhov kev pheej hmoo ntawm lub raum puas tsuaj ntxiv. Tsis tas li ntawd, cistanche kuj pab txo cov roj cholesterol thiab triglyceride uas tuaj yeem ua rau muaj kev phom sij rau cov neeg mob uas muaj kab mob raum.

Nyem rau qhov Kuv Yuav Yuav Cistanche

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david.deng@wecistanche.com WhatApp:86 13632399501

Qhov kev poob qis hauv eGFR yog qhov kev txhawj xeeb tseem ceeb rau ntau tus kws kho mob thiab tseem muaj hnub no. Hauv qhov teeb meem tam sim no ntawm phau ntawv journal, Cherney et al. [4] qhia txog cov teebmeem ntawm sodium-glucose cotransporter (SGLT 2) inhibitor ntawm kev hloov pauv thawj zaug hauv kwv yees glomerular filtration rate (eGFR) thiab piav qhia tias nrog qhov pib poob hauv eGFR, muaj kev cuam tshuam kev txhim kho hauv lub raum kev ua haujlwm lwj dhau sijhawm ( DOI: 10.1159/000524889). Cov kev soj ntsuam no tau ua raws li kev soj ntsuam ua ntej nrog rau lwm yam SGLT 2 inhibitors, ACE inhibitors, thiab angiotensin receptor blockers (ARBs) raws li chav kawm [5]. Cov ntaub ntawv no ntxiv rau peb txoj kev nkag siab tias kev kho kom zoo dua ntawm cov chav kawm tshwj xeeb uas ua rau mob ntshav qab zib mellitus hauv lub raum qeeb qeeb thiab txo cov kab mob plawv (CV) txo qis ntshav siab thiab albuminuria. Txawm li cas los xij, txhua tus muaj qhov pib qis qis hauv eGFR.

Hauv 5 xyoo dhau los, ntxiv rau SGLT2 inhibitors [6, 7], tus neeg sawv cev los ntawm chav kawm tshiab, cov nonsteroidal mineralocorticoid receptor antagonists, finer enone, kuj tau pom tias yuav txo qis hauv lub raum ua haujlwm ntawm cov neeg mob ntshav qab zib, Thaum ntxiv rau cov koob tshuaj ntau tshaj plaws ntawm ACE inhibitors lossis ARB [8]. Cov chav kawm tshuaj no kuj txo cov ntshav siab, txo qis albuminuria, thiab qeeb qhov kev loj hlob ntawm lub raum kab mob, tab sis lawv muaj feem xyuam nrog qhov pib poob hauv GFR uas yog me ntsis tsawg dua li tau piav qhia nrog ACE inhibitors lossis ARB [5, 9] Fig. 1. Qhov sib xws ntawm kev soj ntsuam tias dipping yog txuam nrog kev tiv thaiv cardiorenal yog kev nplij siab rau cov kws kho mob uas saib xyuas qhov kev nce siab hauv cov ntshav creatinine thaum ntxov ntawm kev pib siv tshuaj.

Qhov tseeb mechanism ntawm eGFR dip tsis paub tag nrho. Qee tus neeg xav tias nws tsuas yog qhov txo qis hauv glomerular capillary siab vim qhov txo qis hauv cov ntshav siab thiab xaiv cov teebmeem ntawm cov efferent glomerular arteriolar dilation lossis qee qib ntawm pre-glomerular vasoconstriction, lossis kev sib xyaw ntawm ob. Tej zaum kuj yuav muaj teebmeem rau glomerular ultrafiltration coefficient ib yam nkaus. Qhov loj ntawm kev txo qis hauv eGFR yog qhov ua haujlwm ntawm qhov pib eGFR qhov tseem ceeb; qhov qis dua eGFR, qhov tsawg dua qhov poob [10, 11]. Txawm li cas los xij, qhov sib xws ntawm cov kev soj ntsuam no yog qhov tseem ceeb thaum siv cov tshuaj no hauv kev kho mob, ib leeg lossis ua ke nrog lwm cov tshuaj uas cuam tshuam rau ntshav siab lossis ntshav ntim. Cov kws kho mob yuav tsum paub tias kev hloov pauv hauv GFR yuav tshwm sim thaum pib ntawm cov tshuaj no.

Hauv kev kho mob, cov kws kho mob feem ntau siv cov tshuaj tiv thaiv lub raum nrog rau lwm cov tshuaj tiv thaiv kab mob xws li thiazide thiab thiazide zoo li diuretics. Cov neeg ua haujlwm no pab txhawb tsis tau tsuas yog txo cov ntshav siab zoo xwb tab sis kuj txo qis ntxiv hauv albuminuria. Lawv kuj tuaj yeem ua rau lub cev poob qis nrog cov chav kawm renoprotective ntawm cov tshuaj [5]. Ntau tus kws kho mob tuaj yeem tso tseg ob qho tshuaj diuretics thiab tshuaj tiv thaiv lub raum vim tias qhov pib nce hauv cov ntshav creatinine. Txawm li cas los xij, qhov no tsis yog qhov kev txiav txim siab zoo vim tias cov tshuaj no muaj txiaj ntsig ntev rau lub raum kev ua haujlwm thiab CV cov xwm txheej, thiab kev txuas ntxiv ntawm cov kev kho mob no txo ​​cov kev pheej hmoo mus sij hawm ntev ntawm cov txiaj ntsig kev kho mob tseem ceeb tsis hais txog kev hloov pauv thawj zaug hauv cov ntshav creatinine. . Tsis tas li ntawd, kev tshuaj xyuas ntawm cov kev tshawb fawb laus, qee qhov ntev li ntev li ntawm 10- xyoo rov qab, qhia txog cov txiaj ntsig ntawm kev qeeb qeeb ntawm cov kab mob hauv lub raum nrog kev nce qib hauv cov ntshav creatinine txog li 30 feem pua ​​thaum pib kho [ 12, 13] ib.

Txawm hais tias muaj qhov sib xws ntawm cov txiaj ntsig cardiorenal, ntau tus kws kho mob tsis siv cov tshuaj tiv thaiv lub raum los yog siv rau hauv cov koob tshuaj uas tsis muaj pov thawj ua rau mob raum qeeb. Qhov no yog ib qho kev txhawj xeeb tseem ceeb rau pej xeem kev noj qab haus huv, thiab yuav tsum tau siv zog ntau ntxiv los qhia cov kws kho mob tias cov kev hloov pauv ntawm lub raum tsis zoo yuav tsum tau saib xyuas tab sis yuav tsum tsis yog qhov qhia txog kev txiav tawm ntawm cov tshuaj tiv thaiv cardiorenal. Nrog rau kev nce ntxiv hauv cov ntshav creatinine ntawm 30 feem pua, lossis ntau dua, cov kws kho mob yuav tsum paub tseeb tias lawv cov neeg mob tsis noj cov tshuaj uas tsis yog tshuaj tiv thaiv kab mob, tsis muaj qhov ntim tsis txaus, thiab txiav txim siab tawm qhov tseem ceeb ntawm lub raum hlab ntsha stenosis, yog tias tsim nyog, nrog kev tshuaj xyuas. Cov ntaub ntawv ntau ntxiv txhawb kev siv cov tshuaj no txuas ntxiv. Nws nthuav dav siv cov kev kho mob raum tiv thaiv hauv kev kho mob kom zoo dua ntawm lawv lub peev xwm los ntes tus nqi ntawm kev mob raum thiab kab mob plawv. Qhov no yog tshwm sim los ntawm cov ntaub ntawv ntawm ntau qhov kev tshawb fawb tsis ntev los no [13, 14].

Daim ntawv qhia tsis sib haum xeeb

George Bakris: txhawb nqa los ntawm T32 NIH muab DK07011, tus kws pab tswv yim rau Bayer, KBP Biosciences, Ionis, Alnylam, Astra Zeneca, Quantum Genomics, Qab ntug, Novo Nordisk, Dia Medica Therapeutics, InREGEN. Matthew Weir: txhawb nqa los ntawm R01 DK116095, U01 DK1061022, R01 DK120886, U01 DK129884, thiab kws pab tswv yim: AstraZeneca, Bayer, Merck, Boehringer-Ingelheim, Janssen, Novo Noria,

Cov peev txheej

Tsis muaj nyiaj txiag koom nrog hauv phau ntawv no.

Tus sau kev koom tes

Kev koom tes sib npaug tau ua los ntawm Dr. GL Bakris thiab Dr. MR Weir.

Cov ntaub ntawv

1. Bakris GL, Weir MR. Angiotensin-hloov enzyme inhibitor-koom nrog nce hauv cov ntshav creatinine: qhov no puas yog qhov ua rau muaj kev txhawj xeeb? Arch Intern Med. 2000 Mar 13; 160(5): 685–93.

2. Holtkamp FA, de Zeeuw D, Thomas MC, Cooper ME, de Graeff PA, Hillege HJ, et al. Kev poob qis hauv qhov kwv yees glomerular pom tus nqi thaum kho nrog losartan kwv yees qhov txo qis hauv lub raum ua haujlwm ntev. Raum Int. 2011 Aug; 80(3:282–7.

3. Brenner BM, Cooper ME, de Zeeuw D, Keane WF, Mitch WE, Parving HH, et al. Cov teebmeem ntawm losartan ntawm lub raum thiab cov hlab plawv cov txiaj ntsig hauv cov neeg mob ntshav qab zib hom 2 thiab nephropathy. N Engl J Med. 2001; 345(12):{5}}– 9.

4. Cherney DZI, Cosentino F, Dagogo-Jack S, McGuire D, Pratley RE, Federich R, et al. Thawj eGFR hloov pauv nrog ertugliflozin thiab cov koom haum nrog cov kev kuaj mob: kev tshuaj xyuas los ntawm VERTIS CV mus sib hais. Yog J Nephrol. 2022. (Hauv Xovxwm). PIB: 10.1159/000524889.

5. Kraus BJ, Weir MR, Bakris GL, Mattheus M, Cherney DZI, Sattar N, et al. Tus cwj pwm thiab qhov cuam tshuam ntawm qhov pib kwv yees glomerular pom tus nqi "dip" raws li sodium qabzib cotransporter-2 inhibition nrog empagliflozin hauv EMPA-REG OUTCOME sim. Raum Int. Peb Hlis 2021; 99(3): 750–62.

6. Perkovic V, Jardine MJ, Neal B, Bompoint S, Heerspink HJL, Charytan DM, et al. Canagliflozin thiab lub raum tshwm sim hauv hom 2 mob ntshav qab zib thiab nephropathy. N Engl J Med. 2019 Lub Rau Hli 13; 380 (24): 2295–306.

7. Heerspink HJL, Stefánsson BV, Correa-Rot ter R, Chertow GM, Greene T, Hou FF, et al. Dapagliflozin hauv cov neeg mob uas muaj kab mob raum ntev. N Engl J Med. 2020; 383(15):1436–46.

8. Bakris GL, Agarwal R, Anker SD, Pitt B, Ruilope LM, Rossing P, et al. Cov txiaj ntsig ntawm finer enone ntawm cov kab mob raum ntev tshwm sim hauv hom 2 mob ntshav qab zib. N Engl J Med. 2020; 383(23): 2219–29.

9. Oshima M, Jardine MJ, Agarwal R, Bakris G, Cannon CP, Charytan DM, et al. Kev nkag siab los ntawm CREDENCE mus sib hais qhia qhov kev poob qis hauv qhov kwv yees glomerular pom tus nqi thaum kho nrog canagliflozin nrog rau qhov cuam tshuam rau kev kho mob. Raum Int. 2021 Plaub Hlis Ntuj; 99(4): 999–1009.

10. Bakris G, Oshima M, Mahaffey KW, Agarwal R, Cannon CP, Capuano G, et al. Kev cuam tshuam ntawm Canagliflozin hauv cov neeg mob uas muaj eGFR<30 mL/min per 1.73 m2: subgroup analysis of the randomized CREDENCE trial. Clin J Am Soc Nephrol. 2020 Dec 7;15(12):1705–14. 

11. Jardine MJ, Zhou Z, Mahaffey KW, Oshima M, Agarwal R, Bakris G, et al. Lub raum, cov hlab plawv, thiab cov txiaj ntsig kev nyab xeeb ntawm canagliflozin los ntawm lub raum ua haujlwm hauv lub raum: ib qho kev soj ntsuam thib ob ntawm CREDENCE randomized sim. J Am Soc Nephrol. Peb Hlis 2020; 31(5): 1128–39.

12. Appel LJ, Wright JT, Greene T, Agodoa LY, Astor BC, Bakris GL, et al. Intensive ntshav siab tswj nyob rau hauv hypertensive mob raum kab mob. N Engl J Med. 2010; 363(10):918–29.

13. Collard D, Brouwer TF, Olde Engberink RHG, Zwinderman AH, Vogt L, van den Yug BH. Qhov pib kwv yees glomerular pom tus nqi poob qis thiab lub raum ua haujlwm ntev lub sijhawm thaum siv tshuaj tiv thaiv kab mob siab: kev tshuaj xyuas tom qab hoc ntawm SPRINT thiab AC CORD-BP randomized tswj kev sim. Ntshav siab. Lub Tsib Hlis 2020; 75(5): 1205-12.

14. Beddhu S, Shen J, Cheung AK, Kimmel PL, Chertow GM, Wei G, et al. Qhov cuam tshuam ntawm kev poob qis thaum ntxov hauv eGFR vim yog kev tswj hwm BP ntau rau cov txiaj ntsig ntawm cov hlab plawv hauv SPRINT. J Am Soc Nephrol. 2019 Aug; 30(8):1523–33.

Yog xav paub ntxiv: david.deng@wecistanche.com WhatApp:86 13632399501