患教-肾功能与您的移植器官幻灯片.pptVIP

肾功能与您的新器官 - 普乐可复新生会系列健康课程 - 800 820 6711 400 820 6711 ;目 录;拥有良好的肾功能，是您移植术后获得肾脏健康的重要途径 ;监测移植后的肾脏功能;了解您的肾功能 - 血液检测;了解您的肾功能 - 血液检测参考指标;了解您的肾功能 - 尿液检测;了解您的肾功能 -了解您的肌酐水平;肾功能下降的常见原因;解析钙调磷酸酶抑制剂（CNI）的肾毒性;CNI肾毒性的发病机制和临床特点 不同CNI肾毒性的比较 发生CNI肾毒性的危险因素 CNI肾毒性的预防和治疗 小结 ;急性CNI肾毒性的发病机制和临床特点可逆性的、血流动力学介导的功能性肾功能不全;肾小球前血管持续收缩;对肾脏血流灌注的影响不同 对移植物纤维化的影响不同 对TGF-?1的影响不同 纤维化相关基因表达不同 对P糖蛋白的影响不同 对移植受者的结局（肾功能、存活率）影响不同;Nankivell BJ, Chapman JR, Bonovas G, et al. Oral cyclosporine but not tacrolimus reduces renal transplant blood flow. Transplantation. 2004; 77(9): 1457-9. ;A：Mohamed MA, Robertson H, Booth TA, et al. Active TGF-beta1 expression in kidney transplantation: a comparative study of cyclosporin-A (CyA) and tacrolimus (FK506). Transpl Int. 2000;13 Suppl 1:S295-8. B：Bicknell GR, Williams ST, Shaw JA, et al. Differential effects of cyclosporin and tacrolimus on the expression of fibrosis-associated genes in isolated glomeruli from renal transplants. Br J Surg. 2000; 87(11): 1569-75. ;对P糖蛋白的影响不同他克莫司组P糖蛋白表达高于环孢素组;A：Israni A, Brozena S, Pankewycz O, et al. Conversion to tacrolimus for the treatment of cyclosporine-associated nephrotoxicity in heart transplant recipients. Am J Kidney Dis. 2002 Mar;39(3):E16. B：Lucey MR, Abdelmalek MF, Gagliardi R, et al. A comparison of tacrolimus and cyclosporine in liver transplantation: effects on renal function and cardiovascular risk status. Am J Transplant. 2005; 5(5):1111-9. ;Jurewicz WA. Tacrolimus versus cyclosporin immunosuppression: long-term outcome in renal transplantation. Nephrol Dial Transplant. 2003 May;18 Suppl 1:i7-11. ;Ekberg H, Tedesco-Silva H, Demirbas A, et al. Reduced exposure to calcineurin inhibitors in renal transplantation. N Engl J Med 2007;357:2562-75.;Webster AC, Woodroffe RC, Taylor RS, et al. Tacrolimus versus ciclosporin as primary immunosuppression for kidney transplant recipients: Meta-analysis and meta- regression of randomised trial data. BMJ, 2005, 331: 810.;循环中环孢素和他克莫司水平 肾脏中环孢素和他克莫司水平 环孢素和他克莫司的代谢产物 CNI肾毒性的肾脏易感因素;环孢素