{"id":2036,"date":"2020-12-02T09:15:55","date_gmt":"2020-12-02T00:15:55","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=2036"},"modified":"2020-12-02T10:59:49","modified_gmt":"2020-12-02T01:59:49","slug":"%e6%85%a2%e6%80%a7%e8%85%8e%e8%87%93%e7%97%85%e3%81%ae%e9%80%b2%e8%a1%8c%e3%81%ab%e5%af%be%e3%81%99%e3%82%8b%e5%b0%bf%e9%85%b8%e9%99%8d%e4%b8%8b%e7%99%82%e6%b3%95%e3%81%ae%e6%9c%89%e7%94%a8%e6%80%a7","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=2036","title":{"rendered":"\u6162\u6027\u814e\u81d3\u75c5\u306e\u9032\u884c\u306b\u5bfe\u3059\u308b\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u306e\u52b9\u679c"},"content":{"rendered":"

\u203b\u3053\u306e\u6642\u671f\u306eUpToDate\u306b\u3042\u308b\u201dWhat\u2019s new in family medicine\u201d\u306eTopic\u3067\u53c2\u8003\u306b\u3055\u308c\u3066\u3044\u308b\u6587\u732e\u3067\u3059\u3002<\/p>\n

\uff0d\u6587\u732e\u540d\uff0d
\nBadve SV, Pascoe EM, et al. Effects of Allopurinol on the Progression of Chronic Kidney Disease. N Engl J Med. 2020;382(26):2504. <\/p>\n

\uff0d\u8981\u7d04\uff0d
\n\u3010\u80cc\u666f\u3011
\n\u8840\u6e05\u5c3f\u9178\u5024\u306e\u4e0a\u6607\u306f\u6162\u6027\u814e\u81d3\u75c5\u306e\u9032\u884c\u3068\u95a2\u9023\u3057\u3066\u3044\u308b\uff0e\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u306b\u3088\u308b\u5c3f\u9178\u964d\u4e0b\u7642\u6cd5\u304c\uff0c\u9032\u884c\u30ea\u30b9\u30af\u306e\u3042\u308b\u6162\u6027\u814e\u81d3\u75c5\u60a3\u8005\u306b\u304a\u3051\u308b\u63a8\u5b9a\u7cf8\u7403\u4f53\u6ffe\u904e\u7387\uff08eGFR\uff09\u306e\u4f4e\u4e0b\u3092\u6e1b\u8870\u3055\u305b\u308b\u3053\u3068\u304c\u3067\u304d\u308b\u304b\u3069\u3046\u304b\u306f\u4e0d\u660e\u3067\u3042\u308b\u3002<\/p>\n

\u3010\u7814\u7a76\u306e\u30c7\u30b6\u30a4\u30f3\u3068\u65b9\u6cd5\u3011\u3053\u306eRCT\u306f\uff0c\u30aa\u30fc\u30b9\u30c8\u30e9\u30ea\u30a2\u3068\u30cb\u30e5\u30fc\u30b8\u30fc\u30e9\u30f3\u30c9\u306e31\u65bd\u8a2d\u3067\u884c\u308f\u308c\u305f\uff0c\u4e8c\u91cd\u76f2\u691c\u5316\uff0c\u96a0\u853d\u5316\u3055\u308c\u305f\u8a66\u9a13\u3067\u3042\u308b\uff0e\u75db\u98a8\u306e\u65e2\u5f80\u304c\u306a\u3044\uff0c\u30b9\u30c6\u30fc\u30b8 3 \u307e\u305f\u306f 4\uff08eGFE15-59\uff09 \u306eCKD\u60a3\u8005\u3067\u3042\u308a\uff0c\u5c3f\u4e2d\u30a2\u30eb\u30d6\u30df\u30f3\/\u30af\u30ec\u30a2\u30c1\u30cb\u30f3\u6bd4\u304c 265 mg\/gCr\u4ee5\u4e0a\u3001\u307e\u305f\u306f\u904e\u53bb 1 \u5e74\u9593\u306eeGFR \u306e\u4f4e\u4e0b\u5e45\u304c 3.0 ml\/min\/1.73m2\u4ee5\u4e0a\u3067\u3042\u308b\u6210\u4eba\u96c6\u56e3\u3092\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\uff08100\uff5e300 mg\/\u65e5\uff09\u6295\u4e0e\u90e1\u3068\u30d7\u30e9\u30bb\u30dc\u6295\u4e0e\u7fa4\u306b\u7121\u4f5c\u70ba\u306b\u5272\u308a\u4ed8\u3051\u305f\uff0e\u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\uff0c104\u9031\u76ee\uff082\u5e74\u9593\uff09\u307e\u3067\u306eeGFR\u306e\u5909\u5316\uff0e\u526f\u6b21\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\uff0c\u300c40\uff05\u306eEGFR\u4f4e\u4e0b\u30fb\u672b\u671f\u814e\u75be\u60a3\u30fb\u5168\u6b7b\u4ea1\u306e\u8907\u5408\u30a2\u30a6\u30c8\u30ab\u30e0\u300d\uff0c\u300c30\uff05\u306eEGFR\u4f4e\u4e0b\u30fb\u672b\u671f\u814e\u75be\u60a3\u30fb\u5168\u6b7b\u4ea1\u306e\u8907\u5408\u30a2\u30a6\u30c8\u30ab\u30e0\u300d\uff0c\u300c\u814e\u81d3\u30a2\u30a6\u30c8\u30ab\u30e0\u300d\u300c\u8840\u5727\u300d\u300c\u30a2\u30eb\u30d6\u30df\u30f3\u5c3f\u300d\u300c\u8840\u6e05\u5c3f\u9178\u5024\u300d\uff0c\u300cQOL\u306e\u30b9\u30b3\u30a2\u300d\uff0c\u300c\u5b89\u5168\u6027\u30a2\u30a6\u30c8\u30ab\u30e0\u300d\uff0e<\/p>\n

\"JC202014\u9ed2\u5ca9\uff11\"<\/a><\/p>\n

\u3010\u7d50\u679c\u3011
\n\u4e88\u5b9a\u3057\u3066\u3044\u305f\u767b\u9332\u6570\u306f620\u4f8b\u3060\u3063\u305f\u304c\uff0c\u767b\u9332\u6570\u304c\u4f38\u3073\u306a\u304b\u3063\u305f\u305f\u3081\uff0c369\u4f8b\u3067\u52df\u96c6\u3092\u7d42\u4e86\u3057\uff0c\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u6295\u4e0e\u7fa4\uff08185\u4f8b\uff09\u307e\u305f\u306f\u30d7\u30e9\u30bb\u30dc\u6295\u4e0e\u7fa4\uff08184\u4f8b\uff09\u306b\u7121\u4f5c\u70ba\u306b\u5272\u308a\u4ed8\u3051\u305f\uff0e1\u7fa4\u3042\u305f\u308a3\u4eba\u306e\u60a3\u8005\u304c\u5272\u308a\u4ed8\u3051\u5f8c\u3059\u3050\u306b\u8f9e\u9000\u3057\u305f\u3002\u6b8b\u3063\u305f363\u4f8b\u3067\u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\u3092\u8a55\u4fa1\u3057\u305f\u3002\uff08\u5e73\u5747eGFR\u306f31.7 ml\/min\/1.73m2\u3001\u5c3f\u4e2d\u30a2\u30eb\u30d6\u30df\u30f3\/\u30af\u30ec\u30a2\u30c1\u30cb\u30f3\u6bd4\u4e2d\u592e\u5024\u306f716.9mg\/gCr\u3001\u5e73\u5747\u8840\u6e05\u5c3f\u9178\u5024\u306f8.2mg\/dL\uff09
\n\u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\u3067\u3042\u308beGFR\u306e\u5909\u5316\u306f\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u7fa4\u3068\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u6709\u610f\u5dee\u306f\u8a8d\u3081\u3089\u308c\u306a\u304b\u3063\u305f\uff08\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u7fa4\u306f-3.33 ml\/min\/1.73m2\uff3b95\uff05\u4fe1\u983c\u533a\u9593{CI}\uff0c-4.11\uff5e-2.55\uff3d\uff0c\u30d7\u30e9\u30bb\u30dc\u7fa4\u306f-3.23 ml\/min\/1.73m2\uff3b95\uff05CI\uff0c-3.98\uff5e-2.47\uff3d\uff0c\u5e73\u5747\u5dee\u306f-0.10 ml\/min\/1.73m2\uff3b95\uff05\u4fe1\u983c\u533a\u9593{CI}\uff0c\u22121.18 ~0.97\uff1bP\uff1d0.85\uff3d\u3067\u3042\u3063\u305f\uff09\uff08FIG1\uff09\u3002<\/p>\n

\"JC202010\u9ed2\u5ca9\uff12\"<\/a><\/p>\n

\"JC202010\u9ed2\u5ca9\uff13\"<\/a><\/p>\n

\u526f\u6b21\u30a2\u30a6\u30c8\u30ab\u30e0\u306b\u3064\u3044\u3066\u306f\uff0c
\n\u300ceGFR\u306e40\uff05\u4f4e\u4e0b\u3001\u672b\u671f\u814e\u75be\u60a3\u3001\u5168\u6b7b\u4ea1\u306e\u8907\u5408\u30a2\u30a6\u30c8\u30ab\u30e0\u300d\u306f\uff0c\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u7fa4\u3067\u306f63\u4f8b\uff0835\uff05\uff09\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u306f51\u4f8b\uff0828 \uff05\uff09\u306b\u8a8d\u3081\u3089\u308c\u305f\uff0e\uff08\u30ea\u30b9\u30af\u6bd4\u30011.23\uff1b95\uff05CI\u30010.90\uff5e1.67\uff1b\u30cf\u30b6\u30fc\u30c9\u6bd4\u30011.34\uff1b95\uff05CI\u30010.92\uff5e1.9\uff09\u3067\u3042\u3063\u305f\u3002\u300cGFR\u306e40\uff05\u4f4e\u4e0b\u3001\u672b\u671f\u814e\u75be\u60a3\u3001\u5168\u6b7b\u4ea1\u306e\u8907\u5408\u30a2\u30a6\u30c8\u30ab\u30e0\u300d\u306b\u3064\u3044\u3066\u3082\u4f3c\u305f\u3088\u3046\u306a\u7d50\u679c\u3067\u3042\u3063\u305f\uff0e(TABLE2)<\/p>\n

\"JC202010\u9ed2\u5ca9\uff14\"<\/a><\/p>\n

\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u5024\u3092\u8abf\u6574\u3057\u305f\u5834\u5408\u306e\u8840\u6e05\u5c3f\u9178\u5024\u306e\u5e73\u5747\u5dee\u306f\uff0c -2.7mg\/dL\u3067\u3042\u3063\u305f\uff0895\uff05CI\u3001-3.0\uff5e-2.5\uff09(Fig2A)\u3002\u5c3f\u4e2d\u30a2\u30eb\u30d6\u30df\u30f3\/\u30af\u30ec\u30a2\u30c1\u30cb\u30f3\u6bd4\u306b\u306f\u6709\u610f\u306a\u7fa4\u9593\u5dee\u306f\u8a8d\u3081\u3089\u308c\u306a\u304b\u3063\u305f(fig2B\uff09\uff0e\u53ce\u7e2e\u671f\u8840\u5727\uff08\u5e73\u5747\u5dee\u3001-1.79mmHg\uff1b95\uff05CI\u3001-4.69\uff5e1.11\uff09\u307e\u305f\u306f\u62e1\u5f35\u671f\u8840\u5727\uff08\u5e73\u5747\u5dee\u3001-3.21mmHg\uff1b95\uff05CI\u3001-6.82\uff5e3.40\uff09\u3001\u307e\u305f\u306fQOL\u30b9\u30b3\u30a2\uff0836\u9805\u76ee\u306e\u77ed\u547d\u5065\u5eb7\u8abf\u67fbQOL\u30b5\u30de\u30ea\u30fc\u30b9\u30b3\u30a2\u306e\u5e73\u5747\u5dee\u3001-4.4\uff1b95\uff05CI\u3001-10.5\uff5e1.6\uff09\u306b\u304a\u3044\u3066\u3082\u6709\u610f\u306a\u7fa4\u9593\u5dee\u306f\u8a8d\u3081\u3089\u308c\u306a\u304b\u3063\u305f\uff0e<\/p>\n

\"JC202010\u9ed2\u5ca9\uff15\"<\/a><\/p>\n

\u91cd\u7be4\u306a\u6709\u5bb3\u4e8b\u8c61\u304c\u5831\u544a\u3055\u308c\u305f\u306e\u306f\uff0c\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u7fa4\u3067182\u4f8b\u4e2d84\u4f8b\uff0846\uff05\uff09\uff0c\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u306f181\u4f8b\u4e2d79\u4f8b\uff0844\uff05\uff09\u3067\u3042\u3063\u305f\uff08Table3\uff09\uff0e
\n\u91cd\u7be4\u306a\u6709\u5bb3\u4e8b\u8c61\u306f\u4e21\u7fa4\u3067\u540c\u7a0b\u5ea6\u306e\u983b\u5ea6\u3067\u767a\u751f\u3057\u305f\uff08\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u7fa4\u3067\u306f84\u4eba[46\uff05]\u306e\u53c2\u52a0\u8005\u3067170\u4ef6\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u306f79\u4eba[44\uff05]\u306e\u53c2\u52a0\u8005\u3067167\u4ef6\uff09\uff08\u88683\u304a\u3088\u3073\u8868S6\uff09\u3002\u767a\u75b9\u3092\u542b\u3080\u975e\u91cd\u7be4\u306a\u526f\u4f5c\u7528\u306e\u30ea\u30b9\u30af\u306b\u306f\u6709\u610f\u5dee\u306f\u306a\u304b\u3063\u305f\u3002
\n\"JC202010\u9ed2\u5ca9\uff16\"<\/a><\/p>\n

\u3010Discussion\u3011
\nCKD\u3067\u9032\u884c\u30ea\u30b9\u30af\u306e\u9ad8\u3044\u60a3\u8005\u306b\u304a\u3044\u3066\uff0c\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u306b\u3088\u308b\u5c3f\u9178\u964d\u4e0b\u7642\u6cd5\u306f\uff0c\u30d7\u30e9\u30bb\u30dc\u3068\u6bd4\u8f03\u3057\u3066eGFR\u306e\u4f4e\u4e0b\u3092\u9045\u3089\u305b\u308b\u3053\u3068\u306f\u3067\u304d\u306a\u304b\u3063\u305f\u3002
\n\u4eca\u56de\u306e\u7d50\u679c\u306f\u3001\u8840\u6e05\u5c3f\u9178\u5024\u304cCKD\u306e\u9032\u884c\u306b\u56e0\u679c\u95a2\u4fc2\u304c\u3042\u308b\u3068\u3044\u3046\u898b\u89e3\u3092\u652f\u6301\u3059\u308b\u3082\u306e\u3067\u306f\u306a\u3044\u3088\u3046\u3067\u3042\u308b\u3002\u89b3\u5bdf\u7814\u7a76\u304b\u3089\u5f97\u3089\u308c\u305f\u8a3c\u62e0\u306f\u3001\u5c3f\u9178\u5024\u3068\u6162\u6027\u814e\u81d3\u75c5\u306e\u9032\u884c\u3068\u306e\u9593\u306b\u95a2\u9023\u6027\u304c\u3042\u308b\u3060\u3051\u3067\u3001\u56e0\u679c\u95a2\u4fc2\u306f\u306a\u3044\u3053\u3068\u3092\u793a\u3057\u3066\u3044\u308b\u3002<\/p>\n

\u3010\u4eca\u56de\u306e\u7814\u7a76\u306e\u9650\u754c\u3011
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\n\u30fb\u8a66\u9a13\u30ec\u30b8\u30e1\u30f3\u3092\u4e2d\u6b62\u3057\u305f\u60a3\u8005\u306e\u5272\u5408\u304c\u9ad8\u304b\u3063\u305f\u3053\u3068
\n\u30fbeGFR\u306e\u8a08\u7b97\u306b\u8840\u6e05\u30af\u30ec\u30a2\u30c1\u30cb\u30f3\u30d9\u30fc\u30b9\u306e\u5f0f\u3092\u4f7f\u7528\u3057\u3066\u3044\u305f\u3053\u3068
\n\u30fb\u4ee3\u66ff\u30a2\u30a6\u30c8\u30ab\u30e0\u306e\u4f7f\u7528<\/p>\n

\u3010\u958b\u50ac\u65e5\u30112020\u5e7410\u670814\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

\u203b\u3053\u306e\u6642\u671f\u306eUpToDate\u306b\u3042\u308b\u201dWhat\u2019s new in family medicine\u201d\u306eTopic\u3067\u53c2\u8003\u306b\u3055\u308c\u3066\u3044\u308b\u6587\u732e\u3067\u3059\u3002 \uff0d\u6587\u732e\u540d\uff0d Badve SV, Pascoe EM, et al. Effects … \u7d9a\u304d\u3092\u8aad\u3080 \u6162\u6027\u814e\u81d3\u75c5\u306e\u9032\u884c\u306b\u5bfe\u3059\u308b\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u306e\u52b9\u679c<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[33,17],"tags":[],"class_list":["post-2036","post","type-post","status-publish","format-standard","hentry","category-whats-new","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2036","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2036"}],"version-history":[{"count":4,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2036\/revisions"}],"predecessor-version":[{"id":2046,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2036\/revisions\/2046"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2036"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2036"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2036"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}