中国血液净化2023年4月第22卷第4期Chin J B1 ood Purif,Apri1,2023,Vol.22,No.04●241●·专家共识·血管紧张素受体-脑啡肽酶抑制剂在慢性肾脏病患者中应用的中国专家共识血管素张素受体一脑啡肽酶抑制剂在慢性肾脏病患者中应用的中国专家共识专家组【摘要】慢性肾脏病(chronic kidney disease,CKD)是一个全球性公共卫生问题。心血管疾病是导致CKD患者死亡的首位病因，在CD早期心血管事件的发病率和患病率已经显著升高，并随着肾功能下降呈指数升高，超过50%的我国透析患者死于心脑血管疾病。如何控制心血管事件发生的危险因素，改普预后是CXD的诊治重点。收缩压干预试验(systolic blood pressure intervention tri-al,SPRINT)研究也证实CKD患者通过强化降压在降低心脑血管事件上的获益。血压不佳不仅增加心血管事件发生风险，还会促进CKD进展。近年来，不断有研究证实在CD患者中，首个血管紧张素受体-脑啡肽酶抑制剂(angiotensin receptor-neprilysin inhibitor,ARNI)沙库巴曲缬沙坦较肾素-血管紧张素系统抑制剂可进一步有效降低血压，改善合并心力衰竭患者的预后。在此，为更好地指导ARNI在CKD患者中的应用，减少CD患者心血管事件的发生，由中关村肾病血液净化创新联盟专家组结合循证证据及临床使用经验，制定本共识。【关键词】慢性肾脏病：共识：血管紧张素受体-脑蜂肽酶抑制剂：高血压中图分类号：R692文献标识码：Adoi:10.3969/j.issn.1671-4091.2023.04.001Application of Angiotensin Receptor-Neprilysin Inhibitor in Chronic Kidney Disease Patients:Chi-nese Expert Consensus Chinese Expert Group Consensus on Application of Angiotensin Receptor-Nepri-lysin Inhibitor in Chronic Kidney Disease Patients'Zhongguancun Nephrology&Blood Purification In-novation Alliance,Beijing 100044,ChinaCorresponding author:ZUO Li,Email:ZuoLiMD@Hotmail.com[Abstract]Chronic kidney disease (CKD)is a global public health problem,and cardiovascular dis-ease is the most common cause of death in patients with CKD.The incidence and prevalence of cardiovas-cular events during the early stages of CKD increases significantly with a decline in renal function.Morethan 50%of dialysis patients die from cardiovascular disease.Therefore,developing effective methods tocontrol risk factors and improve prognosis of cardiovascular disease is the primary focus during the diagno-sis and treatment of CKD.For example,the Systolic blood pressure intervention trial (SPRINT)study dem-onstrated that CKD drugs are effective in reducing cardiovascular and cerebrovascular events by control-ling blood pressure.Uncontrolled blood pressure not only increases the risk of these events but also accel-erates the progression of CKD.Recent studies have repeatedly confirmed that the first and so far the onlyangiotensin receptor neprilysin inhibitor (ARNI)sacubitril/valsartan can reduce blood pressure more ef-fectively than renin-angiotensin system inhibitors and improve the prognosis of heart failure in patientswith CKD.Here,to better guide the application of ARNI in patients with CKD,and reduce the occurrenceof cardiovascular events,we formulate a consensus based on clinical evidence and experience.[Key words]Chronic kidney disease;Consensus;Angiotensin receptor-neprilysin inhibitor;Hyper-tension慢性肾脏病(chronic kidney disease,CKD)是al Outcomes,KDIGO)提出了结合病因估算的肾小球一个全球性的公共卫生问题，近期研究表明我国滤过率(estimated glomerular filtration rate,CKD患病率为7.18%，现有CKD患者约1.32亿，占全eGFR)和尿白蛋白水平的CKD分期标准，其中eGFR水球的1/5。CKD通常呈进展性，2012年改善全球肾平与尿白蛋白/肌酐比均与不良预后相关。脏病预后组织(Kidney Disease:Improving Glob-CKD患者心血管事件风险明显升高，心血管疾作者单位：100044北京，'中关村肾病血液净化创新联盟通讯作者：左力100044北京，北京大学人民医院肾内科Emai1:ZuoLiMDOHotmai1.com万方数据
