透析療法ネクスト XXVI

出版社: 医学図書出版
著者:
発行日: 2019-11-30
分野: 臨床医学:内科  >  腎臓
ISBN: 9784865173499
電子書籍版: 2019-11-30
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シリーズ第26弾!
「CKD-MBD管理の進歩―日本発Evocalcetへの期待と展望―」と題し、特集・座談会を収載しています。

目次

  • 座談会
    ■エボカルセトをより安全かつ有効に使用するために

    特集  CKD-MBD管理の進歩─日本発Evocalcetへの期待と展望─
    ■1.疾患概念、治療ストラテジーの流れ
     1)CKD-MBDの変遷 ─グローバル編─
    はじめに
    CKD-MBDの概念の広がり
    貧血分野とMBD分野の結合
    鉄と血管石灰化
    Permissive hypocalcemiaとCa負荷
    活性型ビタミンDに対する風当たり
    まとめ
     2)RODからCKD-MBDへ ─日本編─
    はじめに
    1960年代から1980年代のROD
    1990年代以降のROD
    RODからCKD-MBDへ
    おわりに

    ■2.2HPT治療 ─シナカルセトとエボカルセト─
     1)CaSRの歴史:GPCR研究の古典的常識への挑戦の歴史 
    はじめに
    CaSRがクローニングされる前─イオンがアゴニストになることへの挑戦
    CaSRのクローニング─議論の終結
    カルシミメティクスの登場─GPCR創薬への新たな展開
    AHHの原因となるブロッキング型自己抗体、そしてユニークな自己抗体の発見
    AHHのユニークな自己抗体が発信する今後の課題
    自己免疫性副甲状腺低下症と免疫チェックポイント阻害薬
       ─新しい薬がもたらす新しい疾患
    おわりに
     2)Ca受容体作動薬の創製と薬理学的特性 ─シナカルセトからエボカルセトへ─
    はじめに
    シナカルセトの登場
    シナカルセトの問題点
    エボカルセトの創製
    エボカルセトの薬理特性
    おわりに
     3)シナカルセト治療がもたらした2HPT治療変革
    はじめに
    高度の2HPTに対するシナカルセトの効果
    シナカルセトの生命予後改善効果とPTx症例の減少
    シナカルセトによるfibroblast growth factor-23(FGF-23)低下効果およびその臨床的意義
    シナカルセトが骨折におよぼす影響
    おわりに
     4)EVOLVE試験から学ぶ
    はじめに
    CKD-MBDにおけるSHPT管理の重要性
    VDRAの登場からカルシミメティクスの展開
    EVOLVE試験の仮説
    EVOLVE試験の登録症例数3,883人
    EVOLVE試験の研究実施体制
    EVOLVEの統計解析計画
    EVOLVEにおける症例追跡率97.9%
    EVOLVEにおける主要な解析結果
    EVOLVEで事前に想定された割付治療の中止
    EVOLVE試験で事前に設定したラグ・センサリング
    EVOLVE試験で経験された意外なトラブル
    サンプルサイズに対する工夫
    EVOLVEの副次的な結果
    心血管死亡か非心血管死亡か
    CKD-MBD領域で不足しているエビデンス
    おわりに
     5)日本発エボカルセトの治療成績統括 ─世界への発信─ 
    Calcimimetics(カルシウム受容体作動薬)の登場
    日本発のエボカルセトの登場
    エボカルセトの今後
     6)血液透析患者に対するエボカルセト治療(1) 
    はじめに
    シナカルセトとエテルカルセチドの消化器症状の検討
    エボカルセトの消化器症状
    考察
    おわりに
     7)血液透析患者に対するエボカルセト治療(2)
    はじめに
    副甲状腺ホルモン低下作用
    Ca、P値への影響
    Mg値への影響
    肝機能
    消化器症状
    心電図QT時間
    薬剤内服遵守
    おわりに
     8) 腹膜透析患者に対するエボカルセト治療
    はじめに
    カルシミメティクス
    エボカルセト
    腹膜透析患者に対するエボカルセト治療
    おわりに
     9)低Ca血症と致死性不整脈リスク
    はじめに
    シナカルセトとエボカルセトによる低Ca血症の頻度
    低Ca血症による不整脈発生機序
    低Ca血症と突然死
    カルシミメティクス投与時の至適血清Ca濃度は?
     10)消化器症状とその対策 ─エボカルセトの有用性─ 
    はじめに
    シナカルセト
    エボカルセト
    当院の成績
    おわりに
     11) CKD-MBD管理の進歩 ─日本発エボカルセトへの期待と展望─
    はじめに
    生命予後の重視によって何が変わったか?
    骨・ミネラル代謝異常の何が心血管イベントリスクになるのか?
    CKD-MBD治療におけるカルシウム受容体作動薬の役割
    そして再び骨病変へ
    おわりに

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

座談会

P.9 掲載の参考文献
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特集 CKD - MBD 管理の進歩 - 日本発 Evocalcet への期待と展望 -

P.17 掲載の参考文献
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