{"id":2380,"date":"2023-08-16T11:23:24","date_gmt":"2023-08-16T02:23:24","guid":{"rendered":"https:\/\/www.hcfm.jp\/journal\/?p=2380"},"modified":"2023-08-16T11:23:24","modified_gmt":"2023-08-16T02:23:24","slug":"%e3%82%a2%e3%83%ad%e3%83%97%e3%83%aa%e3%83%8e%e3%83%bc%e3%83%ab%e3%81%afckd%e3%81%ae%e9%80%b2%e8%a1%8c%e3%82%92%e6%8a%91%e5%88%b6%e3%81%99%e3%82%8b%e3%81%8b%ef%bc%9f","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=2380","title":{"rendered":"\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u306fCKD\u306e\u9032\u884c\u3092\u6291\u5236\u3059\u308b\u304b\uff1f"},"content":{"rendered":"

\uff0d\u6587\u732e\u540d\uff0d
\nSunil V. Badve, Elaine M. Pascoe, M.Biostat,\u3000et al.\u3000Effects of Allopurinol on the Progression of Chronic Kidney Disease. N Engl J Med.2020; 382(26):2504-2513.
\n\uff0d\u8981\u7d04\uff0d
\nIntroduction
\n\u3000\u8840\u6e05\u5c3f\u9178\u5024\u306e\u4e0a\u6607\u306f\u3001\u6162\u6027\u814e\u81d3\u75c5(\u4ee5\u4e0bCKD)\u306e\u9032\u884c\u3068\u95a2\u9023\u3057\u3066\u3044\u308b\u3002\u3057\u304b\u3057\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u306b\u3088\u308b\u5c3f\u9178\u5024\u4f4e\u4e0b\u6cbb\u7642\u304c\u3001\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\u91cf(eGFR)\u306e\u4f4e\u4e0b\u3092\u6291\u5236\u3067\u304d\u308b\u304b\u3069\u3046\u304b\u306f\u5206\u304b\u3063\u3066\u3044\u306a\u3044\u3002
\nMethod
\n\u30aa\u30fc\u30b9\u30c8\u30e9\u30ea\u30a2\u3068\u30cb\u30e5\u30fc\u30b8\u30fc\u30e9\u30f3\u30c9\u306e31\u65bd\u8a2d\u306b\u304a\u3044\u3066\u7121\u4f5c\u70ba\u5316\u6bd4\u8f03\u8a66\u9a13\u3092\u5b9f\u65bd\u3002Stage3\u307e\u305f\u306f\uff14(eGFR15~59 mL\/\u5206\/1.73 m2)\u306eCKD\u60a3\u8005\u3067\u75db\u98a8\u306e\u65e2\u5f80\u304c\u306a\u304f\u3001\u5c3f\u4e2d\u30a2\u30eb\u30d6\u30df\u30f3\/\u30af\u30ec\u30a2\u30c1\u30cb\u30f3\u6bd4\u304c265mg\/g\u30fbCre\u4ee5\u4e0a\u3001\u307e\u305f\u306f\u524d\u5e74\u304b\u30893.0mL\/\u5206\/1.73 m2\u4ee5\u4e0a\u306eeGFR\u6e1b\u5c11\u304c\u8a8d\u3081\u3089\u308c\u305f\u6210\u4eba\u306b\u3001\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\uff08100\uff5e300mg\/\u65e5\uff09\u307e\u305f\u306f\u30d7\u30e9\u30bb\u30dc\u3092\u30e9\u30f3\u30c0\u30e0\u306b\u5272\u308a\u4ed8\u3051\u305f\u3002\u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u3001\u7121\u4f5c\u70ba\u5316\u304b\u3089104\u9031\u76ee\u307e\u3067\u306e\u3001\u6162\u6027\u814e\u81d3\u75c5\u75ab\u5b66\u5171\u540c\u7814\u7a76(CKD-EPI)\u306e\u30af\u30ec\u30a2\u30c1\u30cb\u30f3\u5f0f(\u2605)\u3092\u7528\u3044\u3066\u7b97\u51fa\u3057\u305feGFR\u5909\u5316\u3067\u3042\u3063\u305f\u3002
\n(\u2605)
\n\"\"<\/a><\/p>\n

Results
\n\u3000620\u4f8b\u306e\u3046\u3061369\u4f8b\u304c\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb(185\u4f8b)\u307e\u305f\u306f\u30d7\u30e9\u30bb\u30dc(184\u4f8b)\u306b\u7121\u4f5c\u70ba\u306b\u5272\u308a\u4ed8\u3051\u3089\u308c\u305f\u5f8c\u3001\u52df\u96c6\u304c\u9045\u308c\u305f\u305f\u3081\u767b\u9332\u304c\u505c\u6b62\u3055\u308c\u305f\u3002\u5404\u7fa43\u540d\u306e\u60a3\u8005\u304c\u7121\u4f5c\u70ba\u5316\u5f8c\u3059\u3050\u306b\u8131\u843d\u3057\u305f\u3002
\n\u6b8b\u308a\u306e363\u4f8b(\u5e73\u5747eGFR31.7 mL\/\u5206\/1.73 m2\u3001\u5e73\u5747\u5c3fALB\/Cre\u6bd4\u4e2d\u592e\u5024716.9mg\/g\u30fbCre\u3001\u5e73\u5747\u8840\u6e05\u5c3f\u9178\u50248.2mg\/dL)\u3092\u4e3b\u8981\u8a55\u4fa1\u9805\u76ee\u3068\u3057\u3066\u7d44\u307f\u5165\u308c\u305f\u3002eGFR\u306e\u5909\u5316\u306f\u3001\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u7fa4\u3068\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u6709\u610f\u5dee\u306f\u306a\u304b\u3063\u305f\u3002
\n\uff08\u305d\u308c\u305e\u308c\u3001\uff0d3.33 mL\/\u5206\/1.73 m2\/\u5e74\uff3b95%\u4fe1\u983c\u533a\u9593\uff5bCI\uff5d\u3001\uff0d4.11\uff5e\uff0d2.55\uff3d\u3001\u304a\u3088\u3073\uff0d3.23 mL\/\u5206\/1.73 m2\/\u5e74\uff3b95%\u4fe1\u983c\u533a\u9593\uff5bCI\uff5d\u3001\uff0d3.98\uff5e\uff0d2.47\uff3d\u3067\u3042\u3063\u305f\uff1a\u5e73\u5747\u5dee\u3001\uff0d0.10 mL\/\u5206\/1.73 m2\/\u5e74\uff3b95%\u4fe1\u983c\u533a\u9593\uff5bCI\uff5d\u3001\uff0d1.18\uff5e0.97\uff3d\uff1bP=0.85\uff09\u3002\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u7fa4\u306e\u5e73\u5747\u8840\u6e05\u5c3f\u9178\u5024\u306f\uff0c12\u9031\u76ee\u306b5.1 mg\/dL\uff0895% CI, 4.8 to 5.3\uff09\u306b\u4f4e\u4e0b\u3057\uff0c104\u9031\u76ee\u307e\u30675.3 mg\/dL\uff0895% CI, 5.1 to 5.6\uff09\u3067\u7dad\u6301\u3055\u308c\u305f\u3002\u4e00\u65b9\u3067\u30d7\u30e9\u30bb\u30dc\u7fa4\u306e12\u9031\u6642\u70b9\u306e\u5e73\u5747\u8840\u6e05\u5c3f\u9178\u5024\u306f8.2 mg mg\/dL\uff0895% CI, 7.9 to 8.5\uff09\u3067\u3001\u8ffd\u8de1\u671f\u9593\u4e2d\u306f8.2 mg\/dL\uff0895% CI, 7.9 to 8.4\uff09\u3067\u7dad\u6301\u3055\u308c\u305f\u3002\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u5024\u3092\u8abf\u6574\u3057\u305f\u8840\u6e05\u5c3f\u9178\u5024\u306e\u5e73\u5747\u5dee\u306f-2.7 mg\/dL\uff0895% CI, -3.0 to -2.5\uff09\u3060\u3063\u305f\u3002\u91cd\u7be4\u306a\u6709\u5bb3\u4e8b\u8c61\u306f\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u7fa4\u3067\u306f182\u4f8b\u4e2d84\u4f8b(46%)\u3001\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u306f181\u4f8b\u4e2d79\u4f8b(44%)\u3067\u5831\u544a\u3055\u308c\u305f\u3002<\/p>\n

\"\"<\/a><\/p>\n

\u60a3\u8005\u306e\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u7279\u6027\u306f\u3001\u814e\u81d3\u75c5\u306e\u4e3b\u539f\u56e0\u3092\u9664\u3044\u3066\u3001\u5272\u308a\u4ed8\u3051\u3089\u308c\u305f\u6cbb\u7642\u7fa4\u9593\u3067\u30d0\u30e9\u30f3\u30b9\u304c\u3068\u308c\u3066\u3044\u305f\u3002\u5e73\u5747\uff08\u00b1SD\uff09eGFR\u306f31.7\u00b112.0ml\/\u5206\/1.73m2\u3001\u5c3f\u4e2d\u30a2\u30eb\u30d6\u30df\u30f3\/\u30af\u30ec\u30a2\u30c1\u30cb\u30f3\u6bd4\u4e2d\u592e\u5024\u306f716.9mg\/g\u30fbCre\uff08\u56db\u5206\u4f4d\u7bc4\u56f2\u3001244.3\u301c1857\uff09\u3001\u8840\u6e05\u5c3f\u9178\u5024\u306e\u5e73\u5747\u306f8.2\u00b11.8 mg\/deciliter\uff08490\u00b1110\u03bcmol\/L\uff09\u3067\u3042\u3063\u305f\u3002<\/p>\n

\"\"<\/a><\/p>\n

\u56f31. \u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u306e\u63a8\u5b9a\u7cf8\u7403\u4f53\u6ffe\u904e\u91cf\uff08eGFR\uff09\u306b\u5bfe\u3059\u308b\u52b9\u679c\u3002
\neGFR\u306b\u5bfe\u3059\u308b\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u3068\u30d7\u30e9\u30bb\u30dc\u306e\u52b9\u679c\u3092\u793a\u3059\u3002I\u30d0\u30fc\u306f95\uff05\u4fe1\u983c\u533a\u9593\u3092\u793a\u3059\u3002
\neGFR\u306e\u5909\u5316\u306f\u3001\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u7fa4\u3068\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u6709\u610f\u5dee\u306f\u306a\u304b\u3063\u305f\u3002<\/p>\n

\"\"<\/a><\/p>\n

\"\"<\/a><\/p>\n

\u56f32. \u8840\u6e05\u5c3f\u9178\u5024\u3068\u30a2\u30eb\u30d6\u30df\u30f3\u5c3f\u306b\u5bfe\u3059\u308b\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u306e\u52b9\u679c
\n\u8840\u6e05\u5c3f\u9178\u5024\uff08\u30d1\u30cd\u30ebA\uff09\u304a\u3088\u3073\u5c3f\u4e2d\u30a2\u30eb\u30d6\u30df\u30f3\uff1a\u30af\u30ec\u30a2\u30c1\u30cb\u30f3\u6bd4\uff08\u30d1\u30cd\u30ebB\uff09\u306b\u5bfe\u3059\u308b\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u3068\u30d7\u30e9\u30bb\u30dc\u306e\u52b9\u679c\u3092\u793a\u3059\u3002<\/p>\n

\"\"<\/a><\/p>\n

Discussion
\n\u767b\u9332\u304c\u4e0d\u5b8c\u5168\u3067\u3042\u3063\u305f\u305f\u3081\u691c\u51fa\u529b\u304c\u4e0d\u5341\u5206\u3067\u3042\u3063\u305f\u3053\u3068\u3001\u8a66\u9a13\u30ec\u30b8\u30e1\u30f3\u3092\u4e2d\u6b62\u3057\u305f\u60a3\u8005\u306e\u5272\u5408\u304c\u9ad8\u304b\u3063\u305f\u3053\u3068\u3001eGFR\u306e\u7b97\u51fa\u306b\u8840\u6e05\u30af\u30ec\u30a2\u30c1\u30cb\u30f3\u30d9\u30fc\u30b9\u306e\u5f0f\u3092\u7528\u3044\u305f\u3053\u3068\u3001\u4ee3\u66ff\u30a2\u30a6\u30c8\u30ab\u30e0\u3092\u7528\u3044\u305f\u3053\u3068\u306a\u3069\u3001\u3044\u304f\u3064\u304b\u306e\u5927\u304d\u306a\u9650\u754c\u304c\u3042\u3063\u305f\u3002\u307e\u305f\u30a4\u30aa\u30d8\u30ad\u30bd\u30fc\u30eb\u306a\u3069\u306e\u5916\u56e0\u6027\u7cf8\u7403\u4f53\u6ffe\u904e\u30de\u30fc\u30ab\u30fc\u306e\u8840\u6f3f\u30af\u30ea\u30a2\u30e9\u30f3\u30b9\u3092\u7528\u3044\u305f\u7cf8\u7403\u4f53\u6ffe\u904e\u91cf\u306e\u6e2c\u5b9a\u3092\u884c\u308f\u306a\u304b\u3063\u305f\u3053\u3068\u3082\u5236\u9650\u3068\u306a\u3063\u305f\u3002
\nResult
\n\u6162\u6027\u814e\u81d3\u75c5\u3067\u9032\u884c\u306e\u30ea\u30b9\u30af\u304c\u9ad8\u3044\u60a3\u8005\u306b\u304a\u3044\u3066\u3001\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u306b\u3088\u308b\u5c3f\u9178\u5024\u4f4e\u4e0b\u6cbb\u7642\u306f\u30d7\u30e9\u30bb\u30dc\u3068\u6bd4\u8f03\u3057\u3066eGFR\u4f4e\u4e0b\u3092\u9045\u3089\u305b\u306a\u304b\u3063\u305f\u3002<\/p>\n

\u3010\u958b\u50ac\u65e5\u30112022\u5e749\u670814\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

\uff0d\u6587\u732e\u540d\uff0d Sunil V. Badve, Elaine M. Pascoe, M.Biostat,\u3000et al.\u3000Effects of Allopurinol on the Progression of Chronic … \u7d9a\u304d\u3092\u8aad\u3080 \u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u306fCKD\u306e\u9032\u884c\u3092\u6291\u5236\u3059\u308b\u304b\uff1f<\/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":[17],"tags":[],"class_list":["post-2380","post","type-post","status-publish","format-standard","hentry","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2380","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=2380"}],"version-history":[{"count":3,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2380\/revisions"}],"predecessor-version":[{"id":2390,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2380\/revisions\/2390"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2380"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2380"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2380"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}