Article(id=1291404712138502823, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291404681641713991, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2025.07.005, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1729180800000, receivedDateStr=2024-10-18, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785824476512, onlineDateStr=2026-08-04, pubDate=1744819200000, pubDateStr=2025-04-17, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785824476512, onlineIssueDateStr=2026-08-04, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785824476512, creator=13701087609, updateTime=1785824476512, updator=13701087609, issue=Issue{id=1291404681641713991, tenantId=1146029695717560320, journalId=1246415772164075586, year='2025', volume='41', issue='7', pageStart='901', pageEnd='1050', issueExtLink='null', onlineDate='null', pubDate='1744819200000', pubDateStr='2025-04-17', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785824469242, creator='13701087609', updateTime=1785824469242, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=922, endPage=926, ext={EN=ArticleExt(id=1291404712314663592, articleId=1291404712138502823, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Clinical trial of sodium citrate anticoagulant hemodialysis combined with tacrolimus in the treatment of patients with nephrotic syndrome complicated with acute kidney injury, columnId=1246531407326105792, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Clinical and Basic Bridging Research, runingTitle=null, highlight=null, articleAbstract=
Objective To observe the clinical efficacy and safety of citric acid solution anticoagulant hemodialysis combined with tacrolimus tablets in the treatment of patients with nephrotic syndrome complicated with acute kidney injury.
Methods The patients with nephrotic syndrome complicated with acute kidney injury were randomly divided into control group and treatment group. The control group was given low molecular weight heparin anticoagulation (initial dose 2 000-3 000 U, additional dose 500-1 000 U·h-1) hemodialysis + oral tacrolimus capsule, oral tacrolimus capsules at an initial dose of 0.05 mg·kg-1·d-1, twice a day. The treatment group was given 180 mL·h-1 4% sodium citrate anticoagulant hemodialysis + oral tacrolimus capsules, with an initial dose of 0.05 mg·kg-1·d-1 twice a day. Two groups were treated for 4 weeks. The clinical efficacy, renal function, coagulation function and safety were compared between the two groups.
Results Treatment group was enrolled 85 cases, 2 cases dropped out, and 83 cases were finally included in the statistical analysis. Control group was enrolled 84 cases, 3 cases dropped out, and 81 cases were finally included in the statistical analysis. After treatment, the total effective rates of treatment group and control group were 96.38% (80 cases/83 cases) and 92.59% (75 cases /81 cases), without statistical significance (P>0.05). After treatment, the albumin levels of treatment group and control group were (40.19±7.01) and (35.72±6.12) g·L-1, the serum creatinine levels were (82.39±12.66) and (73.65±11.27) μmoL·L-1, the 24 h urinary proteins were (1.41±0.26) and (1.75±0.31) g, the prothrombin time was (15.32±1.61) and (18.71±1.74) s, the activated partial thrombin time was (46.29±3.08) and (50.23±3.12) s, the thrombin time was (18.01±1.73) and (21.04±1.85) s, the urine output was (1 358.79±397.22) and (1 283.02±378.97) mL·d-1, and the differences of above indexes were statistically significant between two groups (all P<0.05). The adverse drug reactions of treatment group were metabolic alkalosis, metabolic acidosis, hypocalcemia and citric acid accumulation, while those in the control group were bleeding, metabolic alkalosis and metabolic acidosis. The incidences of total adverse drug reactions in treatment and control groups were 16.87% and 14.81%, without statistical significance (P>0.05).
Conclusion Compared with lower molecular weight heparin calcium anticoagulant hemodialysis combined with tacrolimus tablets, sodium citrate anticoagulant hemodialysis combined with tacrolimus tablets can more effectively improve renal function and coagulation function in patients with nephrotic syndrome and acute kidney injury, and will not increase the incidence of adverse drug reactions.
, authors=Yi-jun DONG, Zi-yang ZHANG, Juan XU, Shu ZHOU, Yu-xia SONG, authorsList=Yi-jun DONG, Zi-yang ZHANG, Juan XU, Shu ZHOU, Yu-xia SONG, authorCompany=null, correspAuthors=Shu ZHOU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1291404712679568041, articleId=1291404712138502823, tenantId=1146029695717560320, journalId=1246415772164075586, language=CN, title=枸橼酸钠抗凝血液透析联合他克莫司治疗肾病综合征合并急性肾损伤患者的临床研究, columnId=1246531407485489349, journalTitle=中国临床药理学杂志, columnName=临床与基础桥接研究, runingTitle=null, highlight=null, articleAbstract=
目的 观察枸橼酸钠抗凝血液透析联合他克莫司片治疗肾病综合征合并急性肾损伤患者的临床疗效及安全性。
方法 将肾病综合征合并急性肾损伤患者随机分为对照组和试验组。对照组给予低分子量肝素钙抗凝(首次剂量2 000~3 000 U,追加剂量为500~1 000 U·h-1)血液透析+口服他克莫司胶囊,初始剂量为0.05 mg·kg-1·d-1,每天2次;试验组给予180 mL·h-1 4%枸橼酸钠抗凝血液透析+口服他克莫司胶囊,初始剂量为0.05 mg·kg-1·d-1,每天2次。2组患者均治疗4周。比较2组患者的临床疗效、肾功能、凝血功能,以及安全性。
结果 试验组入组85例,脱落2例,最终有83例纳入统计分析;对照组入组84例,脱落3例,最终有81例纳入统计分析。治疗后,试验组和对照组的总有效率分别为96.38%(80例/83例)和92.59%(75例/81例),在统计学上差异无统计学意义(P>0.05)。治疗后,试验组和对照组的白蛋白水平分别为(40.19±7.01)和(35.72±6.12)g·L-1,血清肌酸酐水平分别为(82.39±12.66)和(73.65±11.27)μmoL·L-1,24 h尿蛋白分别为(1.41±0.26)和(1.75±0.31)g,凝血酶原时间分别为(15.32±1.61)和(18.71±1.74)s,活化部分凝血活酶时间分别为(46.29±3.08)和(50.23±3.12)s,凝血酶时间分别为(18.01±1.73)和(21.04±1.85)s,尿量分别为(1 358.79±397.22)和(1 283.02±378.97)mL·d-1,在统计学上差异均有统计学意义(均P<0.05)。试验组的药物不良反应主要有代谢性碱中毒、代谢性酸中毒、低钙血症和枸橼酸蓄积,对照组的药物不良反应主要有出血、代谢性碱中毒和代谢性酸中毒。试验组和对照组的总药物不良反应发生率分别为16.87%和14.81%,在统计学上差异无统计学意义(P>0.05)。
结论 枸橼酸钠抗凝血液透析联合他克莫司片治疗较低分子量肝素钙抗凝血液透析联合他克莫司片能够更有效地改善肾病综合征合并急性肾损伤患者的肾功能和凝血功能,且不会增加药物不良反应的发生率。
, authors=董义军, 张子阳, 许娟, 周姝, 宋雨霞, authorsList=董义军, 张子阳, 许娟, 周姝, 宋雨霞, authorCompany=null, correspAuthors=周姝, authorNote=
董义军(1987-),男,主治医师,主要从事肾病及血液透析的相关研究
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