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首页> 外文期刊>Journal of pharmacy practice >Individualizing Therapy in Patients With Chronic Kidney Disease
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Individualizing Therapy in Patients With Chronic Kidney Disease

机译:慢性肾脏病患者的个体化治疗

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摘要

Patients with chronic kidney diseases have multiple clinical abnormalities that may affect disposition of drugs, including alterations in glomerular filtration rate, excretion of plasma proteins, reductions in serum albumin, and reductions in drug metabolizing enzyme activity. Inflammation may also influence the previous factors. Concomitant drug therapies can lead to drug-drug interactions that may affect the pharmacokinetics of administered drugs. Pharmacogenomics has begun to be evaluated for effects of genotype and haplotype of drug metabolizing enzymes and transporters on drug disposition. Because of the multiple potential etiologies for alterations in drug disposition in patients with chronic kidney diseases, they require appropriate evaluation for implementation of individualized strategies in therapies to enhance efficacy and reduce toxicities. This review will highlight the disease- and patient-specific variables that are targets for patient-centered approaches to therapeutic interventions. The field of pharmacogenomics will be reviewed with reference to common therapies for transplantation and glomerular diseases.
机译:患有慢性肾脏疾病的患者具有多种临床异常情况,可能会影响药物的处置,包括肾小球滤过率改变,血浆蛋白排泄,血清白蛋白降低以及药物代谢酶活性降低。炎症也可能影响先前的因素。伴随的药物疗法可能导致药物相互作用,从而影响所用药物的药代动力学。药物基因组学已开始评估药物代谢酶和转运蛋白的基因型和单倍型对药物处置的影响。由于慢性肾脏病患者的药物处置有多种潜在的病因,因此,他们需要对适当的评估方法进行个性化治疗,以提高疗效和降低毒性。这篇综述将突出疾病和患者特定的变量,这些变量是以患者为中心的治疗干预方法的目标。药物基因组学领域将参考移植和肾小球疾病的常用疗法进行综述。

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