BỆNH THẬN MẠN & ĐÁI THÁO ĐƯỜNG Từ Sinh lý bệnh đến Điều trị để Cải thiện Tiên lượng

Prof Pham Van Bui Univ.. of Medicine Pham Ngoc ThachNguyen Tri Phuong Hospital President, Society of the Nephrology-Dialysis Therapies Invited Professor, Liege Univ.. of Medicine, Belgiu

Prof Pham Van Bui Univ of Medicine Pham Ngoc Thach

Nguyen Tri Phuong Hospital President, Society of the Nephrology-Dialysis Therapies Invited Professor, Liege Univ of Medicine, Belgium

BỆNH THẬN MẠN & ĐÁI THÁO ĐƯỜNG

Từ Sinh lý bệnh đến Điều trị

để Cải thiện Tiên lượng

CKD-CVD-Diabetes Link: CKD is a Disease Multiplier

ESC 2019: Tầm soát thường xuyên Microalbuminuria để xác định nguy cơ tiến triển bệnh thận hoặc tim mạch trong tương lai

Kidney Function Decline Occurs

Nearly Twice as Fast in Diabetes

15,517 participants, F-U: 26y,

Mean annual decline in eGFR:

Renal Hyperfiltration May Predict Death, CVD

Kanbay M,et al.(2019.) Diabetes Obes Metab 2,doi: 10.1111/dom.13831 Tonelli M, et al (201) Kidney Int 1;80:1306-1314,.

Inrig JK, et al (2007) Clin J Am Soc Nephrol.;2:1215-1222.

Park M, et al.(2015) J Am Soc Nephrol.;26:1426-1433.

• Review :19 studies (3 cross-sectional, 5 prospective, and 11 retrospective): relationship b/w RHF & all-cause mortality, CVE), or CVD indicators

 13/ 15 studies: significant correlation, b/w RHF & mortality,

 7 studies: RHF predicted CVD

 1 study: compared to eGFR of 60 to 74.9 mL/min/1.73 m2 ,

eGFR≥105 mL/min/1.73 m 2 → ↑ 3.7-fold †risk

 Jula K.I: 8941 patients with baseline atherosclerotic CVD →

eGFR≥100 mL/min/1.73 m 2 →↑10 mL/min/1.73 m 2 GFR →↑ 9% risk for † composite end point , CHF, MI, or Stroke

 Minseon PM:43,503 adults /voluntary health screening: RHF →↑†

37% , 30% HTN, CVD

• Conclusion: Better understanding the relationship b/w RHF & CVD is

important → better understand the cogent use of medications that reduce RHF & CVD,

WHICH PATIENTS NEED SOME RENOPROTECTION?

Individuals already with impaired renal function (<60)

Individuals at high-risk of impaired renal function

- fast declining renal function (>10ml/min/3yrs)

DỄ SỬ DỤNG CHÍNH XÁC

AN TOÀN

Kidney–Heart Risk Factor Management

KDIGO Clinical Practice Guideline on Diabetes Management in Chronic Kidney Disease OCT 2020

Practice Point 1.1.1 Patients with diabetes and CKD should be treated with a comprehensive strategy to reduce risks of kidney disease progression and CVD.

Comprehensive

AMAZING KIDNEYS !