慢性肾病

• How does two-weekly administration of erythropoiesis-stimulating agents compare with weekly and monthly administration for people with anemia due to chronic kidney disease who are not on dialysis?
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• How does recombinant human erythropoietin compare with placebo/no treatment in people with anemia of chronic kidney disease who do not require dialysis?
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• How do newer continuous erythropoiesis receptor activators compare with older erythropoiesis-stimulating agents in people with anemia of chronic kidney disease?
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• What are the effects of erythropoiesis-stimulating agents for anemia in adults with chronic kidney disease?
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• In adults with chronic kidney disease and secondary hyperparathyroidism, what are the benefits and harms of cinacalcet?
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• How does calcium compare with alternative phosphate binders for adults with chronic kidney disease–mineral and bone disorder (CKD‐MBD)?
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• How do thienopyridines and recombinant human elastase compare with placebo for increasing patency of arteriovenous fistulae/grafts?
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• What are the benefits and harms of altered dietary salt intake in people with chronic kidney disease?
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证据评分

证据 B 疾病进展、死亡率、以及心血管事件：有中等质量的证据表明，ACEI 类药物相较于对照组药物，在 CKD 患者中具有更好的降压效果。[49]Clase C. Renal failure (chronic). BMJ Clin Evid. 2011 May 25;2011:2004.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217810/http://www.ncbi.nlm.nih.gov/pubmed/21609509?tool=bestpractice.com 系统评价或者受试者＞200名的随机对照临床试验（RCT）。

疾病进展、死亡率、以及心血管事件：有中等质量的证据表明，ACEI 类药物相较于对照组药物，在 CKD 患者中具有更好的降压效果。[49]Clase C. Renal failure (chronic). BMJ Clin Evid. 2011 May 25;2011:2004.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217810/http://www.ncbi.nlm.nih.gov/pubmed/21609509?tool=bestpractice.com

证据 B 疾病进展：有中等质量的证据表明，在延缓慢性肾病患者的疾病进展方面，血管紧张素 Ⅱ 受体拮抗剂与钙通道阻滞剂的效果相近。[63]Segura J, García-Donaire JA, Ruilope LM. Calcium channel blockers and renal protection: insights from the latest clinical trials. J Am Soc Nephrol. 2005 Mar;16 Suppl 1:S64-6.http://jasn.asnjournals.org/content/16/3_suppl_1/S64.longhttp://www.ncbi.nlm.nih.gov/pubmed/15938037?tool=bestpractice.com 系统评价或者受试者＞200名的随机对照临床试验（RCT）。

疾病进展：有中等质量的证据表明，在延缓慢性肾病患者的疾病进展方面，血管紧张素 Ⅱ 受体拮抗剂与钙通道阻滞剂的效果相近。[63]Segura J, García-Donaire JA, Ruilope LM. Calcium channel blockers and renal protection: insights from the latest clinical trials. J Am Soc Nephrol. 2005 Mar;16 Suppl 1:S64-6.http://jasn.asnjournals.org/content/16/3_suppl_1/S64.longhttp://www.ncbi.nlm.nih.gov/pubmed/15938037?tool=bestpractice.com

证据 B 疾病进展：有中等质量的证据表明，尚不清楚他汀类相较于对照组，能够更有效地延缓慢性肾衰竭患者疾病进展或进展至 ESRD。[49]Clase C. Renal failure (chronic). BMJ Clin Evid. 2011 May 25;2011:2004.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217810/http://www.ncbi.nlm.nih.gov/pubmed/21609509?tool=bestpractice.com 系统评价或者受试者＞200名的随机对照临床试验（RCT）。

疾病进展：有中等质量的证据表明，尚不清楚他汀类相较于对照组，能够更有效地延缓慢性肾衰竭患者疾病进展或进展至 ESRD。[49]Clase C. Renal failure (chronic). BMJ Clin Evid. 2011 May 25;2011:2004.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217810/http://www.ncbi.nlm.nih.gov/pubmed/21609509?tool=bestpractice.com

证据 C 疾病进展及终末期肾脏病：有低质量的证据表明，在慢性肾衰竭患者中，ACEI 类药物相比于对照组能够更有效地降低疾病进展和 ESRD 的风险。有质量极低的证据显示，尚不清楚在慢性肾衰竭患者中ACEI类药物是否能够更有效地降低死亡率。[49]Clase C. Renal failure (chronic). BMJ Clin Evid. 2011 May 25;2011:2004.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217810/http://www.ncbi.nlm.nih.gov/pubmed/21609509?tool=bestpractice.com 系统评价或者受试者＞200名的随机对照临床试验（RCT）。

疾病进展及终末期肾脏病：有低质量的证据表明，在慢性肾衰竭患者中，ACEI 类药物相比于对照组能够更有效地降低疾病进展和 ESRD 的风险。有质量极低的证据显示，尚不清楚在慢性肾衰竭患者中ACEI类药物是否能够更有效地降低死亡率。[49]Clase C. Renal failure (chronic). BMJ Clin Evid. 2011 May 25;2011:2004.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217810/http://www.ncbi.nlm.nih.gov/pubmed/21609509?tool=bestpractice.com