\u4eca\u56de\u306f\u9ad8\u5c3f\u9178\u8840\u75c7\u306e\u6cbb\u7642\u306b\u95a2\u3057\u3066\u3088\u308a\u767a\u5c55\u7684\u306a\u5185\u5bb9\u3092\u8a18\u8f09\u3057\u307e\u3057\u305f\u3002\u6700\u521d\u306b\u60a3\u8005\u3055\u3093\u5411\u3051\u306b\u5206\u304b\u308a\u3084\u3059\u304f\u307e\u3068\u3081\u3092\u793a\u3057\u3066\u3001\u305d\u306e\u5f8c\u306b\u8a73\u7d30\u306a\u8aac\u660e\u3092\u8a18\u8f09\u3057\u307e\u3059\u3002<\/p>\n\n\n\n
\u60a3\u8005\u3055\u3093\u5411\u3051\u307e\u3068\u3081<\/p>\n\n\n\n
\u6162\u6027\u814e\u81d3\u75c5\u306a\u3069\u814e\u6a5f\u80fd\u969c\u5bb3\u306b\u4f34\u3063\u3066\u9ad8\u5c3f\u9178\u8840\u75c7\u306b\u306a\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u304c\u3001\u305d\u306e\u5834\u5408\u306f\u539f\u5247\u3068\u3057\u3066\u5c3f\u9178\u751f\u6210\u6291\u5236\u85ac\u306e\u4f7f\u7528\u304c\u52e7\u3081\u3089\u308c\u307e\u3059\u3002<\/p>\n\n\n\n
\u75db\u98a8\u767a\u4f5c\u306e\u65e2\u5f80\u6b74\u306e\u306a\u3044\u9ad8\u5c3f\u9178\u8840\u75c7\u306b\u95a2\u3057\u3066\u306f\u73fe\u6642\u70b9\u3067\u78ba\u7acb\u3057\u305f\u30a8\u30d3\u30c7\u30f3\u30b9\u306f\u3042\u308a\u307e\u305b\u3093\u304c\u3001\u6162\u6027\u814e\u81d3\u75c5\u306a\u3069\u306e\u5408\u4f75\u75c7\u304c\u3042\u308b\u5834\u5408\u306b\u306f\u3001\u8840\u6e05\u5c3f\u9178\u50248.0mg\/dL\u4ee5\u4e0a\u3067\u5c3f\u9178\u964d\u4e0b\u85ac\u306b\u3088\u308b\u6cbb\u7642\u304c\u671b\u307e\u3057\u3044\u3068\u8003\u3048\u307e\u3059\u3002\u5408\u4f75\u75c7\u3092\u6709\u3059\u308b\u7121\u75c7\u5019\u6027\u9ad8\u5c3f\u9178\u8840\u75c7\u3067\u306f\u5408\u4f75\u75c7\u306e\u6cbb\u7642\u3092\u512a\u5148\u3057\uff0c\u3053\u306e\u969b\u306b\u5c3f\u9178\u964d\u4e0b\u4f5c\u7528\u3082\u4f75\u305b\u3082\u3064\u85ac\u7269\u3092\u9078\u629e\u3059\u308b\u3053\u3068\u3067\u85ac\u306e\u6570\u3092\u5897\u3084\u3059\u3053\u3068\u306a\u304f\u8840\u6e05\u5c3f\u9178\u5024\u306e\u4f4e\u4e0b\u3092\u56f3\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059\uff0e\u9ad8\u8840\u5727\u3067\u306f\u30ed\u30b5\u30eb\u30bf\u30f3\u30ab\u30ea\u30a6\u30e0\uff0c\u9ad8LDL\u8840\u75c7\u3067\u306f\u30a2\u30c8\u30eb\u30d0\u30b9\u30bf\u30c1\u30f3\uff0c\u9ad8\u4e2d\u6027\u8102\u80aa\u8840\u75c7\u3067\u306f\u30d5\u30a7\u30ce\u30d5\u30a3\u30d6\u30e9\u30fc\u30c8\uff0c\u7cd6\u5c3f\u75c5\u3067\u306fSGLT2\u963b\u5bb3\u85ac\u3084\u30d4\u30aa\u30b0\u30ea\u30bf\u30be\u30f3\u306a\u3069\u3092\u9078\u629e\u3059\u308b\u3068\u3088\u3044\u3067\u3059\uff0e<\/p>\n\n\n\n
<\/p>\n\n\n\n
CKD\u306b\u4f34\u3046\u9ad8\u5c3f\u9178\u8840\u75c7\u3067\u306e\u8003\u3048\u65b9<\/p>\n\n\n\n
\u75c7\u4f8b2<\/p>\n\n\n\n
65\u6b73\u5973\u6027\uff0e\u7cd6\u5c3f\u75c5\u6027\u814e\u75c7\u306b\u3066\u5916\u6765\u3067\u7d4c\u904e\u89b3\u5bdf\u3055\u308c\u3066\u3044\u307e\u3057\u305f\uff0e<\/p>\n\n\n\n
\u8eab\u9577160 cm\uff0c\u4f53\u91cd65 kg\uff0e\u8840\u5727150\/85 mmHg\uff0c\u8108\u62cd76\/\u5206\uff0c\u6574\uff0e<\/p>\n\n\n\n
\u8840\u6db2\u691c\u67fb\uff1aAlb 3.9 g\/dL\uff0cBUN 24.0 mg\/dL\uff0cCr 2.50 mg\/dL\uff0cUA 8.5 mg\/dL\uff0cHbA1c 7.1\uff05\uff0e<\/p>\n\n\n\n
\u5c3f\u691c\u67fb\uff1a\u86cb\u767d2\uff0b\uff0c\u5c3f\u6f5c\u8840\uff08\uff0d\uff09<\/p>\n\n\n\n
\u672c\u4f8b\u3067\u306e\u9ad8\u5c3f\u9178\u8840\u75c7\u306b\u5bfe\u3057\u3066\u3069\u306e\u3088\u3046\u306b\u5bfe\u5fdc\u3059\u3079\u304d\u3067\u3057\u3087\u3046\u304b\uff1f<\/p>\n\n\n\n
\u5178\u578b\u7684\u306a\u7cd6\u5c3f\u75c5\u6027\u814e\u75c7\u306b\u4f34\u3046\u9ad8\u5c3f\u9178\u8840\u75c7\u306e\u75c7\u4f8b\u3067\u3059\uff0eeGFR 15.9 mL\/\u5206\/1.73 m2\u3067CKD stage 4\u306b\u306a\u308a\u307e\u3059\uff0e\u8840\u6e05\u5c3f\u9178\u5024\u304c8.0 mg\/dL\u4ee5\u4e0a\u3067\u3042\u308a\uff0c\u85ac\u7269\u6cbb\u7642\u306e\u9069\u5fdc\u3068\u8003\u3048\u3089\u308c\u307e\u3059\uff0eCKD\u306b\u4f34\u3046\u9ad8\u5c3f\u9178\u8840\u75c7\u306b\u5bfe\u3057\u3066XOR\u963b\u5bb3\u85ac\u306b\u3088\u308b\u6cbb\u7642\u306f\u814e\u969c\u5bb3\u9032\u5c55\u6291\u5236\u306b\u6709\u52b9\u3067\u3042\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\u307e\u3059\uff0e\u672c\u4f8b\u3067\u306f\u4e2d\u7b49\u5ea6\u4ee5\u4e0a\u306e\u814e\u6a5f\u80fd\u969c\u5bb3\u304c\u3042\u308a\uff0c\u5c3f\u9178\u6392\u6cc4\u4fc3\u9032\u85ac\u306e\u52b9\u679c\u304c\u5f31\u307e\u308b\u3053\u3068\u304c\u60f3\u5b9a\u3055\u308c\u308b\u305f\u3081\uff0c\u539f\u5247\u3068\u3057\u3066\u5c3f\u9178\u751f\u6210\u6291\u5236\u85ac\u306e\u4f7f\u7528\u304c\u52e7\u3081\u3089\u308c\u307e\u3059\uff0e\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u306f\u814e\u6a5f\u80fd\u4f4e\u4e0b\u6642\u306b\u306f\u6295\u4e0e\u91cf\u3092\u6e1b\u3058\u308b\u5fc5\u8981\u304c\u3042\u308a\uff0c\u672c\u4f8b\u3067\u306fCKD stage 4\u3067\u3042\u308b\u305f\u308150 mg\/\u65e5\u304c\u63a8\u5968\u3055\u308c\u307e\u3059\uff0e\u30d5\u30a7\u30d6\u30ad\u30bd\u30b9\u30bf\u30c3\u30c8\u3068\u30c8\u30d4\u30ed\u30ad\u30bd\u30b9\u30bf\u30c3\u30c8\u306f\u80c6\u6c41\u304b\u3089\u306e\u6392\u6cc4\u304c\u3042\u308a\uff0c\u814e\u6a5f\u80fd\u969c\u5bb3\u306e\u3042\u308b\u75c7\u4f8b\u3067\u3082\u4f7f\u7528\u3057\u3084\u3059\u3044\u3067\u3059\uff0e\u305f\u3060\u3057\uff0c\u672c\u4f8b\u306f\u4e2d\u7b49\u5ea6\u4ee5\u4e0a\u306e\u814e\u6a5f\u80fd\u969c\u5bb3\u3092\u8a8d\u3081\u3066\u304a\u308a\uff0c\u5c11\u91cf\u304b\u3089\u958b\u59cb\u3057\u3066\u614e\u91cd\u306b\u6f38\u5897\u3059\u308b\u3053\u3068\u304c\u671b\u307e\u3057\u3044\u3067\u3059\uff0e<\/p>\n\n\n\n
\u25cf\u51e6\u65b9\u4f8b<\/p>\n\n\n\n
\u30d5\u30a7\u30d6\u30ad\u30bd\u30b9\u30bf\u30c3\u30c8\uff08\u30d5\u30a7\u30d6\u30ea\u30af\u00ae\uff091\u56de10 mg 1\u65e51\u56de\uff08\u671d\u98df\u5f8c\uff09<\/p>\n\n\n\n
\u30c8\u30d4\u30ed\u30ad\u30bd\u30b9\u30bf\u30c3\u30c8\uff08\u30a6\u30ea\u30a2\u30c7\u30c3\u30af\u00ae\uff091\u56de20 mg 1\u65e52\u56de\uff08\u671d\u5915\u98df\u5f8c\uff09<\/p>\n\n\n\n
\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\uff08\u30b6\u30a4\u30ed\u30ea\u30c3\u30af\u00ae\uff091\u56de50 mg 1\u65e51\u56de\uff08\u671d\u98df\u5f8c\uff09<\/p>\n\n\n\n
<\/p>\n\n\n\n
\u85ac\u7269\u7642\u6cd5\u5f8cTLS\u3067\u306e\u8003\u3048\u65b9<\/p>\n\n\n\n
\u75c7\u4f8b3<\/p>\n\n\n\n
70\u6b73\u7537\u6027\uff0e\u5de6\u4e0a\u8449\u80ba\u764c\uff0c\u809d\u8ee2\u79fb\u306b\u5bfe\u3057\u3066\u85ac\u7269\u7642\u6cd5\u3092\u65bd\u884c\u3055\u308c\u307e\u3057\u305f\uff0e\u6295\u4e0e\u5f8c4\u65e5\u76ee\u306b\u8840\u6e05\u5c3f\u9178\uff0c\u30ab\u30ea\u30a6\u30e0\uff0c\u30af\u30ec\u30a2\u30c1\u30cb\u30f3\u5024\u304c\u4e0a\u6607\u3057\u307e\u3057\u305f\uff0e<\/p>\n\n\n\n
\u8eab\u9577160 cm\uff0c\u4f53\u91cd55 kg\uff0e\u8840\u5727105\/55 mmHg\uff0c\u8108\u62cd104\/\u5206\uff0c\u6574\uff0e<\/p>\n\n\n\n
\u8840\u6db2\u691c\u67fb\uff1aAlb 2.9 g\/dL\uff0cBUN 35.0 mg\/dL\uff0cCr 2.4 mg\/dL\uff0cUA 13.3 mg\/dL\uff0cNa 132 mEq\/L\uff0cK 6.0 mEq\/L\uff0cCl 102 mEq\/L\uff0e<\/p>\n\n\n\n
\u672c\u4f8b\u3067\u306e\u9ad8\u5c3f\u9178\u8840\u75c7\u306b\u5bfe\u3057\u3066\u3069\u306e\u3088\u3046\u306b\u5bfe\u5fdc\u3059\u3079\u304d\u3067\u3057\u3087\u3046\u304b\uff1f<\/p>\n\n\n\n
\u672c\u4f8b\u3067\u306f\u80ba\u764c\u306b\u5bfe\u3059\u308b\u85ac\u7269\u7642\u6cd5\u5f8c\u306e\u816b\u760d\u5d29\u58ca\u75c7\u5019\u7fa4\uff08TLS\uff09\u304c\u5f37\u304f\u7591\u308f\u308c\u307e\u3059\uff0e\u80ba\u764c\u306fTLS\u767a\u75c7\u4f4e\u30ea\u30b9\u30af\u7fa4\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3059\u304c\uff0c\u8fd1\u5e74\uff0c\u6297\u816b\u760d\u52b9\u679c\u306e\u9ad8\u3044\u5206\u5b50\u6a19\u7684\u6cbb\u7642\u85ac\u306a\u3069\u304c\u4e0a\u5e02\u3055\u308c\uff0c\u767a\u75c7\u983b\u5ea6\u304c\u5897\u52a0\u3059\u308b\u53ef\u80fd\u6027\u304c\u6307\u6458\u3055\u308c\u3066\u3044\u307e\u3059\uff0e\u672c\u4f8b\u3067\u306f\u814e\u6a5f\u80fd\u969c\u5bb3\u304c\u51fa\u73fe\u3057\u3066\u304a\u308a\uff0c\u30e9\u30b9\u30d6\u30ea\u30ab\u30fc\u30bc\u304c\u7b2c1\u9078\u629e\u3068\u8003\u3048\u3089\u308c\u307e\u3059\uff0e\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u306f\uff0c\u5c3f\u9178\u306e\u524d\u99c6\u4f53\u3067\u3042\u308b\u30ad\u30b5\u30f3\u30c1\u30f3\u3084\u30d2\u30dd\u30ad\u30b5\u30f3\u30c1\u30f3\u306e\u6fc3\u5ea6\u3092\u4e0a\u6607\u3055\u305b\uff0c\u30ad\u30b5\u30f3\u30c1\u30f3\u6790\u51fa\u306b\u3088\u308a\u30ad\u30b5\u30f3\u30c1\u30f3\u814e\u75c7\u3092\u767a\u75c7\u3059\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\uff0c\u814e\u6a5f\u80fd\u969c\u5bb3\u304c\u3042\u308b\u672c\u4f8b\u3067\u306f\u4f7f\u7528\u3057\u306b\u304f\u3044\u3067\u3059\uff0e\u30d5\u30a7\u30d6\u30ad\u30bd\u30b9\u30bf\u30c3\u30c8\u306f\uff0c2016\u5e745\u6708\u306b\u300c\u304c\u3093\u5316\u5b66\u7642\u6cd5\u306b\u4f34\u3046\u9ad8\u5c3f\u9178\u8840\u75c7\u300d\u306e\u52b9\u80fd\u30fb\u52b9\u679c\u304c\u8ffd\u52a0\u627f\u8a8d\u3055\u308c\u307e\u3057\u305f\uff0e\u672c\u4f8b\u3067\u306f\u3088\u308a\u3059\u307f\u3084\u304b\u306a\u5c3f\u9178\u4f4e\u4e0b\u4f5c\u7528\u306e\u30e9\u30b9\u30d6\u30ea\u30ab\u30fc\u30bc\u304c\u7b2c1\u9078\u629e\u3067\u3059\u304c\uff0c\u30e9\u30b9\u30d6\u30ea\u30ab\u30fc\u30bc\u3092\u4ee5\u524d\u306b\u6295\u4e0e\u3057\u305f\u3053\u3068\u304c\u3042\u308b\u60a3\u8005\u3067\u306f\uff0c\u30d5\u30a7\u30d6\u30ad\u30bd\u30b9\u30bf\u30c3\u30c8\u3092\u4f7f\u3044\u307e\u3059\uff0e<\/p>\n\n\n\n
\u25cf\u51e6\u65b9\u4f8b<\/p>\n\n\n\n
\u30e9\u30b9\u30d6\u30ea\u30ab\u30fc\u30bc\uff08\u30e9\u30b9\u30ea\u30c6\u30c3\u30af\u00ae\uff090.2 mg\/kg\/\u56de\u30001\u65e51\u56de\u70b9\u6ef4\u3000\u6700\u59277\u65e5\u9593\u6295\u4e0e<\/p>\n\n\n\n
\u30d5\u30a7\u30d6\u30ad\u30bd\u30b9\u30bf\u30c3\u30c8\uff08\u30d5\u30a7\u30d6\u30ea\u30af\u00ae\uff091\u56de60 mg\u30001\u65e51\u56de\u5185\u670d<\/p>\n\n\n\n
<\/p>\n\n\n\n
\u30a2\u30ed\u30d7\u30ea\u30ce\u30fc\u30eb\u306f\u30ad\u30b5\u30f3\u30c1\u30f3\u814e\u75c7\u3092\u767a\u75c7\u3059\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\uff0c\u3084\u3084\u4f7f\u7528\u3057\u306b\u304f\u3044\uff0e<\/p>\n\n\n\n
<\/p>\n\n\n\n
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