Pharmacologic Treatment of Common Symptoms in Dialysis Patients: A Narrative Review
Pharmacologic Treatment of Common Symptoms in Dialysis Patients: A Narrative Review
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DOI：
10.1111/sdi.12378
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发表时间：
2015-07-01
影响因子：
1.6
通讯作者：
Wilson, Francis Perry
中科院分区：
文献类型：
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作者：
Moledina, Dennis G.;Wilson, Francis Perry
接受血液透析的终末期肾病（ESRD）患者经历了疾病相关症状的沉重负担，这导致生活质量下降。本文综述了ESRD相关的药代动力学和治疗躯体症状的药物的疗效。疲劳、瘙痒、失眠和痉挛是终末期肾病最常见的症状，研究表明这些症状往往治疗不足。然而，很少有循证指南存在，以指导治疗的患者接受透析。在这篇综述的背景下，我们研究了左旋肉碱在治疗疲劳和痉挛中的作用;人类生长激素类似物Norditropin和合成代谢类固醇Nandrolone用于治疗疲劳;加巴喷丁和其他药物用于治疗腹膜炎;维生素和肌酸补充剂在透析相关痉挛的管理中，以及透析相关失眠的治疗中的梦游症。治疗决定应与患者协商，充分考虑这些疗法的潜在风险和益处。
End-stage renal disease (ESRD) patients receiving hemodialysis experience a heavy burden of disease-related symptoms, which lead to reduced quality of life. This review focuses on aspects of ESRD-related pharmacokinetics and on efficacy of drugs for treatment of somatic symptoms. Fatigue, pruritus, insomnia, and cramps are the most common symptoms in ESRD, and studies suggest that they are often undertreated. However, few evidence-based guidelines exist to guide therapy in patients received dialysis. In the context of this review, we examine the role of l-Carnitine in the treatment of fatigue and cramps; human growth hormone analog Norditropin and anabolic steroid Nandrolone for the treatment of fatigue; Gabapentin and other agents for the management of pruritis; Vitamin and creatine supplementation in the management of dialysis-associated cramps, and somnambulates in the treatment of dialysis-related insomnia. Treatment decisions should be made in consultation with patients with a full accounting of the potential risks and benefits of these therapies.