ĪģĪģ ĪŦĪé ―üĪĪ ĨŅĨÁĨóĨģ


táŠQ@`f—ÃKƒCƒhƒ‰ƒCƒ“

ƒKƒCƒhƒ‰ƒCƒ“•ķ’†‚Ė•ķŒĢ”ԍ†‚Đ‚įCŠY“–‚·‚é•ķŒĢƒŠƒXƒg‚ÖƒŠƒ“ƒN‚ģ‚ę‚Ü‚·

–ÚŽŸF


„§

‚P
  ‚Š‚ņ–ō•Ļ—Ö@‘OŒã‚Ėt‹@”\•]‰ŋ

CQ1

R‚Š‚ņ–ō“Š—^‚É‚Ļ‚Ŋ‚é—p—Ę’ēß‚Ė‚―‚ß‚Ėt‹@”\•]‰ŋ‚ÉeGFR ‚͐„§‚ģ‚ę‚é‚ЁH

  1. R‚Š‚ņ–ō“Š—^—Ę‚ð’ēŪ‚·‚é‚―‚ß‚Ėt‹@”\•]‰ŋ‚ɂ́CŠģŽŌ‚Š”N—îEŦ•Ę‚ɉž‚ķ‚―•W€“I‚Č‘ĖŠi‚Å‚ ‚ę‚΁C‚·‚Č‚í‚ŋ‰h—{•s—ĮC‹É’[‚Č‚é‚Ē‘‰‚ ‚é‚Ē‚Í‹É’[‚Č”ė–ž‚Š‚Č‚Ŋ‚ę‚ÎeGFR ‚ð—p‚Ē‚é‚ą‚Ƃ𐄏§‚·‚éB
  2. ‰h—{•s—ĮC‹É’[‚Č‚é‚Ē‘‰‚Č‚Į‹Ø“ũ—Ę‚Š•W€’l‚æ‚č‚ā’˜‚ĩ‚­ˆŲ‚Č‚é‚ƍl‚Ķ‚į‚ę‚éŠģŽŌ‚ł́CeGFR ‚ÍGFR ‚ðģŠm‚É”―‰f‚ĩ‚Č‚Ē‚ą‚Æ‚Š‚ ‚éB‚ŧ‚Ė‚æ‚Ī‚Čę‡‚ɂ́CŒŒīCr ’l‚Đ‚į‚ĖeGFR ‚Å‚Í‚Č‚­C’~”A‚É‚æ‚éGFR ‘Š’č‚Č‚Į‘ž‚Ė•û–@‚ð•đ—p‚·‚é‚ą‚Ƃ𐄏§‚·‚éB
  3. ‘ĖŠi‚É‚Đ‚Đ‚í‚į‚ļŒÅ’č—p—Ę‚Š’č‚ß‚į‚ę‚Ä‚Ē‚é–ōÜ‚ɂ‚Ē‚ẮC1.73 m2‚ ‚―‚č‚Ė‘Ė•\–ĘÏ•âģ‚ð‚ĩ‚Č‚ĒƒNƒŒƒAƒ`ƒjƒ“EƒNƒŠƒAƒ‰ƒ“ƒXiCcrj‚Č‚Ē‚ĩeGFRimL/•Šj‚ɉž‚ķ‚―—p—Ę’ēŪ‚ðs‚ĪB
  4. ‘ĖŠi‚ɉž‚ķC‘Ė•\–ĘÏ‚ ‚―‚č‚Å—p—Ę‚Š’č‚ß‚į‚ę‚Ä‚Ē‚é–ōÜ‚ł́C‘Ė•\–ĘÏ•âģi1.73 m2‚ ‚―‚čj‚ðs‚Á‚―Ccr ‚ ‚é‚Ē‚ÍeGFRimL/•Š/1.73 m2j‚ð—p‚Ē‚é‚ą‚Æ‚Š‡—“I‚Å‚ ‚éB
  5. Cockcroft-Gault ŽŪ‚É‚æ‚éCcrimL/•Šj‚ÍJaffé –@‚Å‘Š’č‚ģ‚ę‚―ŒŒīCr ’l‚ð—p‚Ē‚ÄŒvŽZ‚ģ‚ę‚―‚ā‚Ė‚Å‚ ‚éB‚í‚Š‘‚ňę”Ę“I‚ȁCy‘f–@‚Å‘Š’č‚ģ‚ę‚―Cr ’l‚ð—p‚Ē‚éÛ‚ɂ́CŽĀ‘ŠCr ’l‚É0.2 ‚ð‰Á‚Ķ‚éB
„§ƒOƒŒ[ƒh
s‚Ī‚ą‚Æ‚ðŽã‚­„§‚·‚éi’ņˆÄ‚·‚éj
—v@–ņ

R‚Š‚ņ–ō“Š—^—Ę‚ð’ēŪ‚·‚é‚―‚ß‚Ėt‹@”\•]‰ŋ‚ɂ́CŠģŽŌ‚Š”N—îEŦ•Ę‚ɉž‚ķ‚―•W€“I‚Č‘ĖŠi‚Å‚ ‚ę‚΁C‚·‚Č‚í‚ŋ‰h—{•s—ĮC‹É’[‚Č‚é‚Ē‘‰‚ ‚é‚Ē‚Í‹É’[‚Č”ė–ž‚Š‚Č‚Ŋ‚ę‚ÎeGFR ‚ð—p‚Ē‚é‚ą‚Ƃ𐄏§‚·‚éB‰h—{•s—ĮC‹É’[‚Č‚é‚Ē‘‰‚Č‚Į‹Ø“ũ—Ę‚Š•W€’l‚æ‚č‚ā’˜‚ĩ‚­ˆŲ‚Č‚é‚ƍl‚Ķ‚į‚ę‚éŠģŽŌ‚ł́CeGFR ‚ÍGFR ‚ðģŠm‚É”―‰f‚ĩ‚Č‚Ē‚ą‚Æ‚Š‚ ‚éB‚ŧ‚Ė‚æ‚Ī‚Čę‡‚ɂ́CŒŒīCr ’l‚Đ‚įGFR ‚𐄎Z‚·‚é‚Ė‚Å‚Í‚Č‚­C’~”A‚É‚æ‚éGFR ‘Š’č‚Č‚Į‘ž‚Ė•û–@‚ð•đ—p‚·‚é‚ą‚Ƃ𐄏§‚·‚éB‘ĖŠi‚É‚Đ‚Đ‚í‚į‚ļŒÅ’č—p—Ę‚Š’č‚ß‚į‚ę‚Ä‚Ē‚é–ōÜ‚ɂ‚Ē‚ẮC1.73 m2‚ ‚―‚č‚Ė‘Ė•\–ĘÏ•âģ‚ð‚ĩ‚Č‚ĒƒNƒŒƒAƒ`ƒjƒ“EƒNƒŠƒAƒ‰ƒ“ƒXiCcrj‚Č‚Ē‚ĩeGFRimL/•Šj‚ɉž‚ķ‚―—p—Ę’ēŪ‚ðs‚ĪB‘ĖŠi‚ɉž‚ķC‘Ė•\–ĘÏ‚ ‚―‚č‚Å—p—Ę‚Š’č‚ß‚į‚ę‚Ä‚Ē‚é–ōÜ‚ł́C‘Ė•\–ĘÏ•âģi1.73 m2‚ ‚―‚čj‚ðs‚Á‚―Ccr ‚ ‚é‚Ē‚ÍeGFRimL/•Š/1.73 m2j‚ð—p‚Ē‚é‚ą‚Æ‚Š‡—“I‚Å‚ ‚éBCockcroft-Gault ŽŪ‚ð—p‚Ē‚―CcrimL/•Šj‚ÍJaffé –@‚É‚æ‚錌īCr ’l‚ð—p‚Ē‚―‚ā‚Ė‚Å‚ ‚éB‚í‚Š‘‚ňę”Ę“I‚ȍy‘f–@‚É‚æ‚éCr ’l‚ð—p‚Ē‚éÛ‚ɂ́CŽĀ‘ŠCr ’l‚É0.2 ‚ð‰Á‚Ķ‚éB

”wŒiE–Ú“I

ˆĀ‘S‚ÅŒø‰Ę“I‚ȍR‚Š‚ņ‰ŧŠw—Ö@‚ðŽĀŽ{‚·‚é‚―‚߂ɂ́CR‚Š‚ņė—p‚ŠÅ‘åŒĀ”­Šö‚ģ‚ęC•›ė—p‚ðÅŽ‰ŧ‚·‚é‚æ‚Ī‚Č“KØ‚Č–ōÜ—p—Ę‚ĖÝ’č‚Šd—v‚Å‚ ‚éBt”rŸ•Œ^‚Ė–ōÜ‚ɑ΂ĩ‚ẮCt‹@”\áŠQŽž‚É–ōÜ‚Š’~Ï‚ĩd“Ä‚Č•›ė—p‚ŠoŒŧ‚ĩ‚Ī‚é‚―‚߁Ct‹@”\‚ɉž‚ķ‚―—p—Ę’ēß‚Š•K—v‚Æ‚Č‚éB

t‹@”\•]‰ŋ‚É‚ÍGFR ‚ŠŽg—p‚ģ‚ę‚éBŠCŠO‚Å‚ÍGFR •ĻŽŋ‚Å‚ ‚éEDTA ‚âiothalamate ‚ðƒNƒƒ€iCrCchromiumj‚⃈ƒE‘fiIj‚Č‚Į‚Ė•úŽËŦ“ŊˆĘŒģ‘f‚Å•WŽŊ‚ĩ‚―51CriƒNƒƒ€j-EDTA ‚â125I-sodium iothalamate ‚ĖƒNƒŠƒAƒ‰ƒ“ƒX‚ð—p‚Ē‚―GFR ‘Š’č1j‚ŠC‚í‚Š‘‚ł̓CƒkƒŠƒ“EƒNƒŠƒAƒ‰ƒ“ƒX1j‚Šgold standard ‚Å‚ ‚éB‚ĩ‚Đ‚ĩCGFR ‚ðŽĀ‘Š‚·‚é‚―‚߂ɂ̓CƒkƒŠƒ“‚â•úŽËŦ•ĻŽŋ‚É‚æ‚č•WŽŊ‚ĩ‚―ŠOˆöŦƒNƒŠƒAƒ‰ƒ“ƒX•ĻŽŋ‚ðÃ’‚ĩ‚―‚Ī‚Ķ‚ŁC’~”A‚ð•K—v‚Æ‚·‚é‚Ė‚ÅŒŸļ‚Š”ÏŽG‚É‚Č‚éB‚ŧ‚Ė‚―‚ß’Ęí‚ÍŒŒīCr ‚Đ‚įCcr ‚âGFR ‚𐄎Z‚ĩ‚Ä—p‚Ē‚é‚ą‚Æ‚Š‘―‚ĒB‚ģ‚Ü‚ī‚Ü‚ČGFR „ŽZŽŪ‚ŠlˆÄ‚ģ‚ę‚Ä‚Ē‚é‚Šiƒƒ‚1j2-8jC‘å•”•Š‚Í–Ŧt‘Ÿ•aŠģŽŌ‚⌒íŽŌ‚ð‘ΏۂƂĩ‚čėŽ‚ģ‚ę‚Ä‚Ļ‚čC‚Š‚ņŠģŽŌ‚ɑ΂·‚é—LŒøŦ‚͏\•Š‚É‚ÍŒŸØ‚ģ‚ę‚Ä‚Ē‚Č‚ĒB

t‹@”\áŠQ‚Ė‚ ‚éŠģŽŌ‚ɑ΂·‚é—p—Ę’ēß‚́CŽĄŒąŽž‚Ė–ō•Ļ“Ū‘Ô‚Ėƒf[ƒ^‚ÉŠî‚­‚ą‚Æ‚Š‘―‚ĒBt‹@”\‚ɉž‚ķ‚―—p—Ę’ēßŽŽŒą‚́CCockcroft-Gault ŽŪ‚ÉŠî‚­Ccr ‚ð—p‚Ē‚é‚ą‚Æ‚Š‘―‚Đ‚Á‚―B2010 ”N‚ɕč‘‚ĖFDA ‚ŠtáŠQŠģŽŌ‚ɑ΂·‚é–ō•Ļ“Ū‘ÔŒĪ‹†‚ÉŠÖ‚·‚éƒKƒCƒ_ƒ“ƒX‚ð”­•\‚ĩ9jC]—ˆ‚ĖCockcroft-Gault ŽŪ‚É‚æ‚éCcr ‚ɉÁ‚ĶCMDRD ŽŪ‚É‚æ‚éeGFR ‚ð—p‚Ē‚é‚ą‚Æ‚ð’ņĨ‚ĩ‚―‚―‚߁CĄŒãŠJ”­‚ģ‚ę‚é–ōÜ‚ɂ‚Ē‚Ä‚ÍeGFR ‚É‚æ‚é—p—Ę’ēß‚Šˆę”Ę“I‚É‚Č‚é‚Đ‚ā‚ĩ‚ę‚Č‚ĒB‰ĒBˆã–ō•i’ĄiEMAj‚Ė‰ü’ųƒKƒCƒhƒ‰ƒCƒ“ˆÄ‚Å‚āMDRD ŽŪ‚ÆCKD-EPI ŽŪ‚É‚æ‚éeGFR ‚ð—p‚Ē‚―t‹@”\•]‰ŋ‚ɂ‚Ē‚Ä‹LÚ‚ģ‚ę‚Ä‚Ē‚é10jB‚í‚Š‘‚ł́CŒúķ˜J“­Č‚É‚æ‚éuŒoŒûŒŒ“œ~‰š–ō‚Ė—Տ°•]‰ŋ•û–@‚ÉŠÖ‚·‚éƒKƒCƒhƒ‰ƒCƒ“v‚Ė‚Č‚Đ‚ÅCu—Տ°ŽŽŒą‚Ė•]‰ŋ‚É‚Ļ‚Ē‚Đ„§‚ģ‚ę‚éŠÏŽ@€–ځv‚Æ‚ĩ‚āut‹@”\Žw•WieGFRCCcr ‚Č‚Įjv‚ŠŽĶ‚ģ‚ę‚Ä‚Ē‚é11jB‚ą‚ę‚́C–ō•Ļ—p—Ę’ēß‚ÉŠÖ‚·‚é‚ā‚Ė‚Å‚Í‚Č‚Ē‚ŠCĄŒãC‚í‚Š‘‚ĖŽĄŒąŽž‚Ėt‹@”\Žw•W‚Æ‚ĩ‚ÄeGFR ‚Š—p‚Ē‚į‚ę‚é‚ą‚Æ‚Š‘―‚­‚Č‚é‚Đ‚ā‚ĩ‚ę‚Č‚ĒB

–{e‚Ė–Ú“I‚͍R‚Š‚ņ–ō“Š—^‚É‚Ļ‚Ŋ‚ét‹@”\•]‰ŋ–@‚ÉŠÖ‚·‚é‚ą‚ę‚Ü‚Å‚Ė’mŒĐ‚ðŒŸ“Ē‚ĩCŽĀÛ‚Ė—Տ°‚É‚Ļ‚Ŋ‚é‚ŧ‚Ė—L—pŦ‚ÆŒĀŠE‚ð–ū‚į‚Đ‚É‚·‚é‚ą‚Æ‚Å‚ ‚éB

‰ð@ā

–ōÜ‚Ėt”rŸ•Œo˜H‚ÍŽ…‹…‘Ėāh‰ß‚Æ”AŨŠĮ”rŸ•‚Å‚ ‚é‚ŠC”AŨŠĮ‚Ė–ō•Ļ”rŸ•”\‚ð’č—Ę“I‚É•]‰ŋ‚·‚éŠČ•Ö‚Č•û–@‚Í‚Č‚Ē‚―‚߁C’ʏí‚ÍGFR ‚ÉŠî‚ÂĒ‚Ä–ōÜ“Š—^—Ę‚ð’ēß‚·‚éBV‹K–ōÜŠJ”­‚É‚Ļ‚Ē‚Ä‚āCGFR ‚ ‚é‚Ē‚Í‚ŧ‚ę‚ð”―‰f‚·‚éCcr ‚ð—p‚Ē‚Ä—p—Ę‚ŠÝ’č‚ģ‚ę‚é‚ą‚Æ‚Š‘―‚ĒB‚ŧ‚Ė‚―‚߁CR‚Š‚ņ–ō“Š—^Žž‚Ė—p—Ę’ēß‚É‚Ļ‚Ē‚Ä‚āGFR ‚ðŠî€‚Æ‚·‚éB

GFR ‚ð‘Š’č‚·‚é‚ɂ́CŽ…‹…‘Ė‚ÅŠŪ‘S‚Éāh‰ß‚ģ‚ęCƒ^ƒ“ƒpƒNŽŋ‚Č‚Į‚ÉŒ‹‡‚đ‚ļC‘Ė“ā‚Å‘ãŽÓ‚ģ‚ę‚ļC”AŨŠĮ‚Å•Š”å‚āÄ‹zŽû‚ā‚ģ‚ę‚Č‚Ē•ĻŽŋ‚ĖƒNƒŠƒAƒ‰ƒ“ƒX‚ð‘Š’č‚·‚é‚ą‚Æ‚Š•K—v‚Å‚ ‚čCgold standard ‚Æ‚ĩ‚Ä‚í‚Š‘‚ł̓CƒkƒŠƒ“EƒNƒŠƒAƒ‰ƒ“ƒX‚ŠCŠCŠO‚ł́C51CriƒNƒƒ€j-EDTAC125I-sodium iothalamateCiohexol ‚Č‚Į‚ĖƒNƒŠƒAƒ‰ƒ“ƒX‘Š’č‚Š—p‚Ē‚į‚ę‚éBGFR ‚Ė‘ã—p‚Æ‚ĩ‚ÄCcr ‚Š‘Š’č‚ģ‚ę‚é‚ą‚Æ‚ā‚ ‚é‚ŠCCcriy‘f–@j‚̓CƒkƒŠƒ“EƒNƒŠƒAƒ‰ƒ“ƒX‚Å‘Š’č‚ĩ‚―GFR ‚É‚­‚į‚Ũ‚Ä20`30“‚’l‚Æ‚Č‚éB‚ą‚ę‚ÍCr ‚ŠŽ…‹…‘Ė‚Åāh‰ß‚ģ‚ę‚é‚Ų‚Đ‚É”AŨŠĮ‚Đ‚į•Š”å‚ģ‚ę‚é‚―‚ß‚Å‚ ‚čCGFRāCcr~0.715 ‚ĖŠÖŒW‚Š‚ ‚é12jB‚ą‚ę‚į‚Ė•û–@‚́CŽŽ–ō‚Ė“Š—^‚â’~”A‚ð•K—v‚Æ‚ĩCŒ‹‰Ę‚Š•ņ‚ģ‚ę‚é‚Ü‚ÅŽžŠÔ‚ð—v‚·‚é‚ą‚Æ‚Č‚Į‚Đ‚į—Տ°Œŧę‚ÅŽg—p‚·‚é‚ɂ͐§–ņ‚Š‚ ‚éB‚ŧ‚Ė‚―‚ߌŒīCr ’l‚Đ‚įGFR ‚âCcr ‚ð„’č‚·‚鐄ŽZŽŪ‚ŠŠJ”­‚ģ‚ę‚―B

]—ˆ‚ÍCockcroft-Gault ŽŪ‚É‚æ‚鐄ŽZCcr ‚ð—p‚Ē‚Ä—p—Ę’ēß‚ðs‚Ī‚ą‚Æ‚Šˆę”Ę“I‚Å‚ ‚Á‚―B‚ĩ‚Đ‚ĩCcr ‚ÍGFR ‚æ‚č‚’l‚Æ‚Č‚é‚―‚ßGFR ‚ðģŠm‚ɐ„’č‚·‚éŠeŽí‚Ė„ŽZŽŪ‚ŠŠJ”­‚ģ‚ęC–ō•Ļ‚Ė—p—Ę’ēß‚É‚ā—p‚Ē‚į‚ę‚é‚æ‚Ī‚É‚Č‚Á‚Ä‚Ŧ‚―13jBeGFR ‚␄ŽZCcr ‚ĖŒvŽZŽŪ‚Ė‘―‚­‚́CŒ’íl‚▝Ŧt‘Ÿ•aŠģŽŌ‚ð‘ΏۂƂĩ‚čėŽ‚ģ‚ęC‚Š‚ņŠģŽŌ‚ð‘ΏۂƂĩ‚―‚ā‚Ė‚͏­‚Č‚ĒB‚Š‚ņŠģŽŌ‚ð‘ΏۂƂĩ‚―GFR „ŽZŽŪ‚É‚ÍWright ŽŪ5jCMartin ŽŪ6jCJelliffe ŽŪ7j‚Š‚ ‚é‚ŠC“ú–{l‚Š‚ņŠģŽŌ‚ð‘ΏۂƂĩ‚―„ŽZŽŪ‚Í‚Ü‚ūŠJ”­‚ģ‚ę‚Ä‚Ē‚Č‚ĒB‚ŧ‚ą‚ŁCuR‚Š‚ņ–ō“Š—^‚É‚Ļ‚Ŋ‚é—p—Ę’ēß‚Ė‚―‚ß‚Ėt‹@”\•]‰ŋ‚ÉeGFR ‚͐„§‚ģ‚ę‚é‚Ёv‚Æ‚Ē‚ĪƒNƒŠƒjƒJƒ‹EƒNƒGƒXƒ`ƒ‡ƒ“‚ɑ΂ĩ‚āCR‚Š‚ņ–ō“Š—^‚É‚Ļ‚Ŋ‚é—p—Ę’ēß‚Ė‚―‚ß‚Ėt‹@”\•]‰ŋ‚Æ‚ĩ‚āuŒŒīCr ’l‚Đ‚į„ŽZ‚ģ‚ę‚éeGFR ‚́Cgold standard ‚Æ‚ģ‚ę‚éƒCƒkƒŠƒ“EƒNƒŠƒAƒ‰ƒ“ƒX‚â51CriƒNƒƒ€j-EDTAEƒNƒŠƒAƒ‰ƒ“ƒXC125I-sodium iothalamateEƒNƒŠƒAƒ‰ƒ“ƒX‚É‚æ‚éGFR‚Ė‘ã—p‚Æ‚Č‚é‚ЁvCueGFR‚͏]—ˆ—p‚Ē‚į‚ę‚Ä‚Ē‚éCockcroft-Gault ŽŪ‚É‚æ‚éCcr ‚Ė‘ã—p‚Æ‚Č‚é‚Ёv‚Æ‚Ē‚Ī“ņ‚‚Ė–â‚Ē‚ðÝ’č‚ĩC•ķŒĢŒŸõ‚ðs‚Á‚―BŽĀ‘ŠGFR ‚ÆeGFR ‚ð”äŠr‚ĩ‚―ŒĪ‹†‚Í12 Œ14-25jCŽĀ‘ŠCcr ‚ÆeGFR ‚ð”äŠr‚ĩ‚―ŒĪ‹†‚Í3 Œ26-28jCCockcroft-Gault ŽŪ‚É‚æ‚éCcr ‚ÆeGFR ‚Č‚Į‚Ė„ŽZŽŪ‚ð”äŠr‚ĩ‚―ŒĪ‹†‚Í3 Œ‚Å‚ ‚Á‚―29-31jB

‚Š‚ņŠģŽŌ‚ð‘ΏۂɁCŠeŽí„ŽZŽŪ‚Ė‘Ó–Ŧ‚ðŒŸØ‚ĩ‚―ŒĪ‹†‚ĖŒ‹‰Ę‚͈ę’v‚đ‚ļCˆę’č‚Ė”͈͂Ő^‚ĖGFR ‚Ė‰ß‘å•]‰ŋC‰ßŽ•]‰ŋ‚ɂ‚ȂŠ‚é‰Â”\Ŧ‚ŠŽw“E‚ģ‚ę‚Ä‚Ē‚éBGFR ‚Ė‰ß‘å•]‰ŋ‚͍R‚Š‚ņ–ō‚Ė‰ß—Ę“Š—^C•›ė—pƒŠƒXƒN‚Ė‘‰Á‚ɂ‚ȂŠ‚čCGFR ‚Ė‰ßŽ•]‰ŋ‚́CR‚Š‚ņ–ō‚Ė•s\•Š‚Č“Š—^—Ę‚Đ‚įR‚Š‚ņė—p‚ĖŒļŽã‚ɂ‚ȂŠ‚é‰Â”\Ŧ‚Š‚ ‚éB“ú–{l‚Š‚ņŠģŽŌ‚ð‘Ώۂɓú–{t‘ŸŠw‰ï‚ĖeGFR ‚ÆŽĀ‘ŠGFR ‚ð”äŠr‚ĩ‚―ŒĪ‹†‚ā­‚Č‚Ē‚―‚ߍĄŒã‚ĖŒĪ‹†‚Š–]‚Ü‚ę‚éBŒŒīCr ‚Å‚Í‚Č‚­ŒŒīƒVƒXƒ^ƒ`ƒ“C‚Đ‚į‚ĖGFR„ŽZŽŪ‚Ė—L—pŦ‚ÉŠÖ‚·‚éŒĪ‹†‚ā•K—v‚Å‚ ‚ë‚ĪBŒĪ‹†‚Ė‘―‚­‚́Cgold standard ‚Å‚ ‚éŽĀ‘ŠGFR ‚ÆeGFR ‚ð”äŠr‚ĩ‚―‚ā‚Ė‚Å‚ ‚čCeGFR ‚ÉŠî‚ÂĒ‚čR‚Š‚ņ–ō“Š—^‚ðs‚Á‚―ę‡‚ĖŽĄ—ÃŒø‰Ę‚â•›ė—p‚ðŒŸ“Ē‚ĩ‚―‚ā‚Ė‚Å‚Í‚Č‚ĒBeGFR ‚ð—p‚Ē‚―ę‡‚ƁCŽĀ‘ŠGFR ‚ ‚é‚Ē‚ÍCockcroft-Gault ŽŪ‚ð—p‚Ē‚―Ccr ‚ĖC—Տ°“IƒAƒEƒgƒJƒ€‚ð”äŠr‚ĩ‚―ŒĪ‹†‚ā•K—v‚Å‚ ‚éB

ŒŧŽž“_‚ł́C“ú–{t‘ŸŠw‰ï‚Ė„ŽZŽŪ‚ð—p‚Ē‚―eGFR ‚Å‚Ļ‚Ļ‚æ‚ŧ‚Ėt‹@”\‚ð•]‰ŋ‚ĩCt‹@”\‚Šģí‚Å‚ ‚ę‚΍R‚Š‚ņ–ō“Š—^—Ę’ēß‚Í•s—v‚ƍl‚Ķ‚Ä‚æ‚Ē‚Å‚ ‚ë‚ĪB‚―‚ū‚ĩŽĄŒąŽž‚Ėƒf[ƒ^‚ÉŠî‚ÂĒ‚Ä“Š—^—Ę‚ð’ēŪ‚·‚éÛ‚ɂ́C“Ŋ‚ķt‹@”\•]‰ŋ–@‚␄ŽZŽŪ‚ðŽg—p‚ĩ‚Ä•]‰ŋ‚·‚é‚ƈĀ‘S‚Å‚ ‚éB‚Ē‚ļ‚ę‚Ė„ŽZŽŪ‚ð—p‚Ē‚éę‡‚Å‚āCR‚Š‚ņ–ō“Š—^—Ę’ēß‚Š•K—v‚Ȑt‹@”\‚ĖĮ—á‚â‹ŦŠE—Ėˆæ‚ĖĮ—á‚ŁC‘ĖŠi‚Š•W€”͈͂𒘂ĩ‚­ˆí’E‚·‚é‚æ‚Ī‚Čę‡‚ł́CŒŒīCr ’l‚Đ‚į‚ĖeGFR ‚Å‚Í‚Č‚­C’~”A‚É‚æ‚éŽĀ‘ŠGFRiƒƒ‚2j‚âƒVƒXƒ^ƒ`ƒ“C ‚É‚æ‚鐄ŽZGFR ‚Č‚Į‘ž‚Ė•û–@‚ð•đ—p‚·‚é‚ą‚Æ‚ŠˆĀ‘S‚Å‚ ‚ë‚ĪB’~”A‚É‚æ‚éŽĀ‘ŠGFR ‚̓CƒkƒŠƒ“EƒNƒŠƒAƒ‰ƒ“ƒX‚Š–]‚Ü‚ĩ‚Ē‚ŠCŽĀŽ{Ē“ï‚Čę‡‚ɂ́CCcriy‘f–@j‚É0.715 ‚ðæ‚ķ‚ċߎ—‚·‚é•û–@‚ā‚ ‚é12jB

Ccr ‚âGFR ‚ɉž‚ķ‚Ä–ōÜ—p—Ę‚ð’ēß‚·‚éÛ‚É’ˆÓ‚·‚Ũ‚Ŧ“_‚Š‚ ‚éBCcr ‚âGFR ‚ð•]‰ŋ‚·‚éÛC‘Ė•\–ĘÏ•âģ‚ð‚·‚é‚Đ‚Į‚Ī‚Đ‚Æ‚Ē‚Ī“_‚ƁCCockcroft-Gault ŽŪ‚ÉŽg—p‚·‚錌īCr ’l‚Ė‘Š’č–@‚ÉŠÖ‚ĩ‚Ä‚Å‚ ‚éB

–ōÜ—p—ʂ́Ci1jŠģŽŌ‘ĖŠii‘Ėd‚â‘Ė•\–ĘÏj‚É‚Đ‚Đ‚í‚į‚ļˆę’č‚ĖŒÅ’č—p—ʁimg/“új‚Š’č‚ß‚į‚ę‚Ä‚Ē‚éę‡‚ƁCi2jŠģŽŌ‘ĖŠii‘Ėd‚â‘Ė•\–ĘÏj‚ɉž‚ķ‚Ä—p—Ę‚Š’č‚ß‚į‚ę‚Ä‚Ē‚éę‡‚Æ‚Š‚ ‚éB‘ĖŠi‚É‚Đ‚Đ‚í‚į‚ļŒÅ’č—p—Ę‚Š’č‚ß‚į‚ę‚Ä‚Ē‚é–ōÜ‚ɂ‚Ē‚ẮC‘Ė•\–ĘÏ•âģ‚ð‚ĩ‚Č‚ĒCcr ‚Č‚Ē‚ĩeGFRimL/•Šj‚ɉž‚ķ‚―—p—Ę’ēŪ‚ðs‚Īiƒƒ‚3jB‚ą‚ę‚ɂ‚Ē‚ẮC“ú–{t‘ŸŠw‰ï•ŌCKD f—ÃKƒCƒh2012 ‚Å‚āCut‹@”\‚Š’ቚ‚ĩ‚―ŠģŽŌ‚ɐt”rŸ•Ŧ–ō•Ļ‚ðŽg—p‚·‚éÛ‚ɂ́Ct‹@”\‚ð‘Ė•\–ĘÏ‚ð•âģ‚ĩ‚Č‚ĒeGFRimL/•Šj‚Å•]‰ŋ‚ĩ‚Ä–ō•Ļ‚ĖŒļ—Ę‚â“Š—^ŠÔŠu‚Ė‰„’·‚ðs‚Īv‚ą‚Æ‚Š„§‚ģ‚ę‚Ä‚Ē‚é13jBEMA ‚Ėut‹@”\‚Š’ቚ‚ĩ‚―ŠģŽŌ‚Ö‚Ėˆã–ō•i–ō•Ļ“Ū‘Ô•]‰ŋƒKƒCƒhƒ‰ƒCƒ“‰ü’čˆÄv‚āCGFR ‚Í‘Ė•\–ĘÏ•âģ‚ð‚ĩ‚Č‚Ē’l‚Å‘Š’čE•\‹L‚·‚é‚ą‚Ƃ𐄏§‚ĩ‚Ä‚Ē‚é10jBˆę•ûC‘Ė•\–ĘÏimg/m2j‚â‘Ėdimg/kgj‚ ‚―‚č‚Å—p—Ę‚Š’č‚ß‚į‚ę‚Ä‚Ē‚é–ōÜ‚ł́C•W€‘ĖŒ^‚Ė‘Ė•\–ĘÏi1.73 m2j‚Å•âģ‚ĩ‚―Ccr ‚ ‚é‚Ē‚ÍeGFRimL/•Š/1.73 m2j‚ð—p‚Ē‚é‚ą‚Æ‚Š‡—“I‚Å‚ ‚éB‘Ė•\–ĘÏ‚É‰ž‚ķ‚Ä–ō•Ļ—p—Ę‚Š’ēß‚ģ‚ę‚―–ōÜ‚ðCmL/•Š‚ ‚―‚č‚ĖCcr ‚Č‚Ē‚ĩGFR ‚Å•âģ‚ĩ‚―ę‡‚ɂ́C“ņd‚É‘ĖŠi‚ĖˆöŽq‚Š‰Á–Ą‚ģ‚ę‘ĖŠi‚Ė‘å‚Ŧ‚ČŠģŽŌ‚Å‚Í‰ß—Ę“Š—^CŽ‚ģ‚ĒŠģŽŌ‚ł͉ߏŽ“Š—^‚ɂ‚ȂŠ‚é‚Đ‚į‚Å‚ ‚éB‚Č‚ĻCCockcroft-Gault ŽŪ‚ÅŽZo‚ģ‚ę‚éCcr ‚Í‘Ė•\–ĘÏ•âģ‚ģ‚ę‚Ä‚Ē‚Č‚ĒmL/•Š‚ū‚ŠCMDRD ŽŪ‚â“ú–{t‘ŸŠw‰ï‚ĖGFR „ŽZŽŪ‚Å‚Í1.73 m2‚ ‚―‚č‚É‘Ė•\–ĘÏ•âģ‚ģ‚ę‚―’limL/•Š/1.73 m2j‚Æ‚Č‚Á‚Ä‚Ē‚é‚Ė‚Å“K—p‚É‚ ‚―‚Á‚Ä‚Í’ˆÓ‚ĩ‚Č‚­‚Ä‚Í‚Č‚į‚Č‚ĒB

‚í‚Š‘‚ł͍y‘f–@‚ÅCr ’l‚ð‘Š’č‚·‚é‚ą‚Æ‚Š‘―‚Ē‚ŠCCockcroft-Gault ŽŪ‚ÍJaffé –@‚Å‘Š’č‚ģ‚ę‚―Cr ’l‚Đ‚įŒvŽZ‚ģ‚ę‚é‚ą‚Æ‚É’ˆÓ‚·‚é•K—v‚Š‚ ‚éBJaffé–@‚ł͍y‘f–@Cr ’l‚æ‚č0.2 mg/dL ‚‚­‘Š’č‚ģ‚ę‚é‚Ė‚ŁCy‘f–@Cr ’l‚ð—p‚Ē‚ÄCockcroft-Gault ‚ĖCcr ‚ðŒvŽZ‚·‚é‚Æ‚Ŧ‚ɂ́Cy‘f–@Cr ’l‚É0.2 ‚ð‰Á‚Ķ‚éB

‚Č‚ĻC”A˜HŒnŽîᇂɍR‚Š‚ņ–ōŽĄ—Ã‚ð‚·‚éŠģŽŌ‚Ė‚Č‚Đ‚É‚Í•Ðt‚Ė‚ą‚Æ‚Š‚ ‚é‚ŠCeGFR ‚Í—žt‹@”\‚Ė‘˜a‚ð”―‰f‚·‚é‚Ė‚ŁC•ÐtŠģŽŌ‚ɑ΂ĩ‚Ä‚āŽg—p‰Â”\‚Å‚ ‚éB


œ ƒƒ‚1@ŠeŽít‹@”\„ŽZŽŪ

1jCockcroft-Gault ŽŪ2j

„ŽZCcrimL/•Šji140-”N—îj~‘Ėdikgj€i72~ŒŒīCrj

—Ŧ‚͏ã‹L‚Ė’l‚É0.85 ‚ðæ‚ļ‚éBŒŒīCr ’l‚ÍJaffé –@‚Å‘Š’č‚ģ‚ę‚―’l‚ð—p‚Ē‚é‚ŠCy‘f–@‚Å‘Š’č‚ģ‚ę‚―ŒŒīCr ’l‚ɂ́C0.2 ‚ð‰Á‚Ķ‚éB

2j“ú–{t‘ŸŠw‰ï‚ĖGFR „ŽZŽŪ3j

eGFRimL/•Š/1.73 m2j194~ŒŒīCr-1.094~”N—î-0.287
—Ŧ‚͏ã‹L‚Ė’l‚É0.739 ‚ðæ‚ļ‚éB

3jMDRD ŽŪ4j

eGFRimL/•Š/1.73 m2j175~ŒŒīCr-1.154~i”N—îj-0.203~i0.742m—Ŧ‚Ėę‡nj~i1.212m•l‚Ėę‡nj

4jWright ŽŪ5j

eGFRimL/•Šjom6580-i38.8~”N—îjn~‘Ė•\–ĘÏ~m1-0.168~i’jŦ0C—Ŧ1jnp/ŒŒīCr
ŒŒīCr ’l‚ÍJaffé –@‚Å‘Š’čB‘Ė•\–ĘÏ‚Ė„ŽZŽŪ‚ɂ‚Ē‚Ă̓ƒ‚2 ‚ðŽQÆB

5jMartin ŽŪ6j

eGFRimL/•Šjo163~‘Ėdmkgn~m1-i0.00496~”N—îjn~m1-0.252~i’jŦ0C—Ŧ1jnp/ŒŒīCr

6jJelliffe ŽŪ7j

„ŽZCcrimL/•Š/1.73 m2jm98-16i”N—î-20j/20jn/ŒŒīCr
20`80 Î‚Ėę‡B—Ŧ‚ł͏ã‹L‚Ė’l‚É0.9 ‚ðæ‚ļ‚éB

7jCKD-EPI ŽŪ8j

eGFRimL/•Š/1.73 m2j141~iŒŒīCr/ƒČjƒŋ~0.993 ”N—î
ƒČ‚Í’jŦ‚Å0.9C—Ŧ‚Å0.7B
ƒŋ‚ÍŒŒīCr ‚ŠƒČ‚æ‚č‘å‚Ŧ‚Ē‚Æ‚Ŧ‚Í-1.209C‚ŧ‚Ī‚Å‚Č‚Ē‚Æ‚Ŧ‚Í’jŦ‚Í-0.411C—Ŧ‚Í-0.329B
—Ŧ‚Ėę‡‚Í‚ģ‚į‚É1.018 ‚ð‚Đ‚Ŋ‚éB
•l‚Ėę‡‚Í‚ģ‚į‚É1.159 ‚ð‚Đ‚Ŋ‚éB

’FŒŒīCr ’l‚Ė’PˆĘ‚ÍWright ŽŪCMartin ŽŪ‚̓Ęmol/LC‚ŧ‚Ė‘ž‚Ímg/dL

œ ƒƒ‚2@’~”A‚É‚æ‚éŽĀ‘ŠGFR ‚Ė‘Š’č–@

ģŠm‚Ȑt‹@”\•]‰ŋ‚Š•K—v‚Čę‡‚ɂ́CƒCƒkƒŠƒ“EƒNƒŠƒAƒ‰ƒ“ƒX‚Ė‘Š’č‚Š„§‚ģ‚ę‚éB•W€–@‚ÆŠČˆÕ–@‚Š‚ ‚čC•W€–@‚Í1“ƒCƒkƒŠƒ“‚ðŠÜ‚ސķ—H‰–‰t‚ðŽ‘ąÃ’‚ĩC30 •ŠŠÔŠu‚Å’~”A‚Æ’†ŠÔ“_ĖŒŒ‚ð3 ‰ņs‚ĒC3 ‰ņ‚ĖƒNƒŠƒAƒ‰ƒ“ƒX‚Ė•―‹Ï’l‚ð‹‚ß‚é•û–@‚Å‚ ‚éBŠČˆÕ–@‚́CƒCƒkƒŠƒ“‚ĖŽ‘ąÃ’‰š‚Å1 ŽžŠÔ’ö“x‚Ė’~”A‚ðs‚ĒC’~”A‘OŒã‚Å‚ĖĖŒŒ2 ‰ņ‚ŃNƒŠƒAƒ‰ƒ“ƒX‚ð‹‚ß‚é•û–@‚Å‚ ‚éB}‚ɃCƒkƒŠƒ“EƒNƒŠƒAƒ‰ƒ“ƒXŠČˆÕ–@‚ðŽĶ‚·13jBƒCƒkƒŠƒ“EƒNƒŠƒAƒ‰ƒ“ƒX‘Š’č‚É‚ ‚―‚Á‚ẮC–ņ700 mL ‚Ėˆų…•‰‰Ũ‚Š•K—v‚É‚Č‚é‚Ė‚ŁC‘Ė‰t—Ę‰ßč‚Æ‚Č‚į‚Č‚Ē‚æ‚Ī‚É’ˆÓ‚·‚éB

}@ƒCƒkƒŠƒ“EƒNƒŠƒAƒ‰ƒ“ƒXŠČˆÕ–@
}@ƒCƒkƒŠƒ“EƒNƒŠƒAƒ‰ƒ“ƒXŠČˆÕ–@
  1. 1jƒCƒkƒŠƒ““Š—^ŠJŽn45 •ŠŒã‚ÉŠŪ‘S”r”AB”r”AŽž‚ɍĖŒŒB
  2. 2j60 •Š’~”A‚ð–ÚˆĀ‚É”AˆÓ‚Š‚ ‚Á‚―Žž“_‚ōĖ”ABĖ”AŽž‚ɍĖŒŒB
  3. 3j’~”AŽžŠÔ‚ðģŠm‚É‹L˜^B
  4. 4jƒCƒkƒŠƒ“‚ĖŒŒ’†”Z“x‚Í2 “_‚ĖĖŒŒ‚Ė•―‹Ï‚ð—p‚Ē‚éB

“ú–{t‘ŸŠw‰ï•ŌDCKD f—ÃKƒCƒh2012D“Œ‹žˆãŠwŽÐC2012D

œ ƒƒ‚3@‘Ė•\–ĘÏ•âģ‚ð‚ĩ‚Č‚ĒGFR‚Æ‚Í

eGFRimL/•Š/1.73 m2j‚Í•W€“I‚Č‘Ė•\–ĘÏ‚É‚Ļ‚Ŋ‚éGFR ‚ð—\‘Š‚·‚é‚ā‚Ė‚Å‚ ‚čCŒÂX‚ĖŠģŽŌ‚ĖŽĀÛ‚ĖGFR ‚ð•\‚ĩ‚―‚ā‚Ė‚Å‚Í‚Č‚ĒB”N—î•ĘCŦ•Ę‚Ė•W€“I‚Č‘ĖŠi‚Æ‘å‚Ŧ‚­ˆŲ‚Č‚éŠģŽŌ‚ł́CGFR ‚ð‰ß‘å•]‰ŋ‚ĩ‚―‚č‰ßŽ•]‰ŋ‚·‚é‚ą‚Æ‚Š‚ ‚éB‚ŧ‚Ė‚―‚ß–ō•Ļ‚Ė“Š—^ÝŒv‚Å‚Í•K‚ļ‘Ė•\–ĘÏ•âģ‚ð‚ĩ‚Č‚ĒGFRimL/•Šj‚Őt‹@”\‚ð•]‰ŋ‚ĩ‚Č‚Ŋ‚ę‚΂Ȃį‚Č‚ĒB

u‘Ė•\–ĘÏ•âģ‚ð‚ĩ‚Č‚Ēv‚Æ‚Ē‚ĪˆÓ–Ą‚́CGFR ‚Ė’PˆĘ‚ð1.73 m2‚ ‚―‚č‚É•âģ‚·‚é‚Ė‚Å‚Í‚Č‚­CŒÂXl‚ĖŽĀ‘ŠGFR ‚Å•\‚·‚Æ‚Ē‚Ī‚ą‚Æ‚Å‚ ‚éB„ŽZŽŪ‚ÅŒvŽZ‚ģ‚ę‚―”’l‚́C‚·‚Å‚É1.73 m2‚ ‚―‚č‚Ė‘Ė•\–ĘÏ‚É•âģ‚ģ‚ę‚Ä‚Ē‚é‚Ė‚ŁCu‘Ė•\–ĘÏ•âģ‚ð‚ĩ‚Č‚Ēv”’l‚ðŒvŽZ‚·‚é‚ɂ́C–{l‚Ė‘Ė•\–ĘÏ‚ð‹‚ß‚―‚Ī‚Ķ‚ÅˆČ‰š‚Ė‚æ‚Ī‚ÉŒvŽZ‚·‚éB

‘Ė•\–ĘÏ•âģ‚ĩ‚Č‚ĒGFRimL/•ŠjeGFRimL/•Š/1.73 m2j€1.73~–{l‚Ė‘Ė•\–ĘÏim2j

‘Ė•\–ĘÏ‚Ė„ŽZŽŪ‚Æ‚ĩ‚Ä‘ã•\“I‚Č‚ā‚Ė‚ÉDuBois ŽŪ32j‚Š‚ ‚éB

‘Ė•\–ĘÏim2j0.007184~‘Ėdikgj0.425~g’·icmj0.725

yŽQl•ķŒĢz

1j Soveri I, et al.Gfor the SBU GFR Review Group. Measuring GFRFa systematic review. Am J Kidney Dis. 2014G64F411-24. PMIDF24840668

2j Cockcroft DW, et al. Prediction of creatinine clearance from serum creatinine. Nephron. 1976G16F31-41. PMIDF1244564

3j Matsuo S, et al.Gfor the Collaborators developing the Japanese equation for estimated GFR. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009G53F982-92. PMIDF19339088

4j Levey AS, et al.Gfor the Chronic Kidney Disease Epidemiology Collaboration. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006G145F247-54. PMIDF16908915

5j Wright JG, et al. Estimation of glomerular filtration rate in cancer patients. Br J Cancer. 2001G84F452-9. PMIDF11207037

6j Martin L, et al. Improvement of the Cockcroft-Gault equation for predicting glomerular filtration in cancer patients. Bull Cancer. 1998G85F631-6. PMIDF9752271

7j Jelliffe RW. Creatinine clearanceFbedside estimate. Ann Intern Med. 1973G79F604-5. PMIDF4748282

8j Levey AS, et al.Gfor the CKD-EPIiChronic Kidney Disease Epidemiology Collaborationj. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009G150F604-12. PMIDF19414839

9j U.@S. Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and ResearchiCDERj. Guidance for Industry Pharmacokinetics in patients with impaired renal function|study design, data analysis, and impact on dosing and labeling. Draft guidance. 2010.

10j European Medicines Agency. Guideline on the evaluation of the pharmacokinetics of medicinal products in patients with decreased renal function.

11j “Æ—§s­–@lˆã–ō•iˆã—Ë@Ší‘‡‹@\DuŒoŒûŒŒ“œ~‰š–ō‚Ė—Տ°•]‰ŋ•û–@‚ÉŠÖ‚·‚éƒKƒCƒhƒ‰ƒCƒ“v‚ɂ‚Ē‚āD–ōHRļ”­0709 ‘æ1 †i•―Ž22 ”N7 ŒŽ9 “újD

12j –x”öŸ‚Ų‚ЁDt‹@”\‚ɉž‚ķ‚―“Š–ō—Ę‚ĖÝ’č\eGFR Žg—p‚Ė’ˆÓ“_D“ú–{t‘ŸŠw‰ïŽD2008G50F955-8D

13j “ú–{t‘ŸŠw‰ïDCKD f—ÃKƒCƒh2012D“Œ‹žˆãŠwŽÐC2012D

14j Dooley MJ, et al. Carboplatin dosingFgender bias and inaccurate estimates of glomerular filtration rate. Eur J Cancer. 2002G38F44-51. PMIDF11750838

15j Poole SG, et al. A comparison of bedside renal function estimates and measured glomerular filtration rateiTc99mDTPA clearancejin cancer patients. Ann Oncol. 2002G13F949-55. PMIDF12123341

16j Marx GM, et al. Evaluation of the Cockroft-Gault, Jelliffe and Wright formulae in estimating renal function in elderly cancer patients. Ann Oncol. 2004G15F291-5. PMIDF14760124

17j de Lemoss ML, et al. Evaluation of predictive formulae for glomerular filtration rate for carboplatin dosing in gynecological malignancies. Gynecol Oncol. 2006G103F1063-9. PMIDF16875719

18j Shimokata T, et al. Prospective evaluation of pharmacokinetically guided dosing of carboplatin in Japanese patients with cancer. Cancer Sci. 2010G101F2601-5. PMIDF20860621

19j Ainsworth NL, et al. Evaluation of glomerular filtration rate estimation by Cockcroft-Gault, Jelliffe, Wright and Modification of Diet in Renal DiseaseiMDRDjformulae in oncology patients. Ann Oncol. 2012G23F1845-53. PMIDF22104575

20j Hartlev LB, et al. Monitoring renal function during chemotherapy. Eur J Nucl Med Mol Imaging. 2012G39F1478-82. PMIDF22699525

21j Craig AJ, et al. Overestimation of carboplatin doses is avoided by radionuclide GFR measurement. Br J Cancer. 2012G107F1310-6. PMIDF22935580

22j Dooley MJ, et al. Dosing of cytotoxic chemotherapyFimpact of renal function estimates on dose. Ann Oncol. 2013G24F2746-52. PMIDF23928359

23j Shepherd ST, et al. Performance of formulae based estimates of glomerular filtration rate for carboplatin dosing in stage 1 seminoma. Eur J Cancer. 2014G50F944-52. PMIDF24445148

24j Shibata K, et al. Renal function evaluation in patients with cancer who were scheduled to receive carboplatin or S-1. Clin Exp Nephrol. 2015G19F1107-13. PMIDF25894220

25j Hingorani S, et al. Estimating GFR in adult patients with hematopoietic cell transplantFcomparison of estimating equations with an iohexol reference standard. Clin J Am Soc Nephrol. 2015G10F601-10. PMIDF25717073

26j Goto T, et al. Impact of different methods of estimating renal function on determining eligibility for cisplatiniCDDPj-based chemotherapy in patients with invasive urothelial carcinoma. Hinyokika Kiyo. 2011G57F671-6. PMIDF22240299

27j Uozumi J, et al. Is the eGFR formula adequate for evaluating renal function before chemotherapy in patients with urogenital cancer? A suggestion for clinical application of eGFR formula. Clin Exp Nephrol. 2015G19F738-45. PMIDF25281007

28j Inoue N, et al. Are the equations for the creatinine-based estimated glomerular filtration rate applicable to the evaluation of renal function in Japanese children and adult patients receiving chemotherapy? Clin Exp Nephrol. 2015G19F298-308. PMIDF24792810

29j “c’†—C‰Ā‚Ų‚Đ. Modification of Diet in Renal DiseaseiMDRDjŽŪ‚ÉŠî‚ÂĒ‚―—˜_“ICarboplatin “Š—^—Ę‚Ė—Տ°“I‘Ó–Ŧ‚Æ•›ė—p”­ŒŧDŠā‚ƉŧŠw—Ö@D2009G36F2593-8.

30j Launay-Vacher V, et al. Lung cancer and renal insufficiencyFprevalence and anticancer drug issues. Lung. 2009G187F69-74. PMIDF18941834

31j Jennings S, et al. Evaluation of creatinine-based formulas in dosing adjustment of cancer drugs other than carboplatin. J Oncol Pharm Pract. 2010G16F113-9. PMIDF19578094

32j DuBois D, et al. A formula to estimate the approximate surface area if height and weight be known. Arch Intern Med. 1916G17F863-71.


CQ2

R‚Š‚ņ–ō‚É‚æ‚éAKI ‚Ė‘Šúf’f‚ɁCƒoƒCƒIƒ}[ƒJ[‚É‚æ‚é•]‰ŋ‚͐„§‚ģ‚ę‚é‚ЁH

Œŧó‚ł́CR‚Š‚ņ–ō“Š—^‚É‚æ‚éAKI ‚Ė‘Šúf’f‚ɃoƒCƒIƒ}[ƒJ[‚É‚æ‚é•]‰ŋ‚Í‹­‚­„§‚Å‚Ŧ‚Č‚ĒB‚í‚Š‘‚ł́C”A’†ƒ^ƒ“ƒpƒNC”A’†ƒAƒ‹ƒuƒ~ƒ“CŒŒīƒVƒXƒ^ƒ`ƒ“CCƒĀ2 ƒ~ƒNƒƒOƒƒuƒŠƒ“C”A’†NAGC”A’†L-FABP ‚ŠAKI ‚ɑ΂·‚éƒoƒCƒIƒ}[ƒJ[‚Æ‚ĩ‚Ä‘Š’č‰Â”\‚ū‚ŠC‚ŧ‚Ė‘ž‚āŠÜ‚߂āC‚Ē‚Ü‚ūAKI ‚ĖƒoƒCƒIƒ}[ƒJ[‚Æ‚ĩ‚Ä‹­‚­„§‚Å‚Ŧ‚é‚ā‚Ė‚Í‚Č‚ĒB

„§ƒOƒŒ[ƒh
s‚Ī‚ą‚Æ‚ðŽã‚­„§‚·‚éi’ņˆÄ‚·‚éj
—v@–ņ

‚ą‚ą””NCAKI ‚ɑ΂·‚éV‹K‚ĖƒoƒCƒIƒ}[ƒJ[‚Š‚Ē‚­‚‚Еņ‚ģ‚ę‚Ä‚Ē‚éB‚ĩ‚Đ‚ĩĄ“ú‚܂ŁC‚Ē‚ļ‚ę‚ĖƒoƒCƒIƒ}[ƒJ[‚ā“úí—Տ°‚ÅŽg—p‚Å‚Ŧ‚é‚Ų‚Į‚Ė‚‚ĒM—ŠŦCŠī“xCŒŸļE”ŧ’č‚Ėv‘ŽŦ‚ð“ū‚é‚ą‚Æ‚Í‚Å‚Ŧ‚Ä‚Ē‚Č‚ĒB

”wŒiE–Ú“I

① AKI ‚Ėf’fŠî€

2004 ”N‚ÉAcute Dialysis Quality InitiativeiADQIj‚ŠC‰‚ß‚Ä“ˆę‚ģ‚ę‚―AKI ‚Ėf’fŠî€‚ð’ņĨ‚ĩ‚―B‚Į‚ĖŽ{Ý‚Å‚āŠČ’P‚É‘Š’č‚Å‚Ŧ‚錌īCr ‚Æ”A—Ę‚É’…–Ú‚ĩCRIFLEiRisk, Injury, Failure, Loss, End-stage kidney diseasej•Š—Þ‚Æ‚ĩ‚Ä5 ’iŠK‚É‚í‚Ŋ‚į‚ę‚―i•\1j1jB‚ģ‚į‚É2007 ”N‚ÉAKINiAcute Kidney Injury Networkj‚æ‚čAKIN •Š—Þ‚Š’ņĨ‚ģ‚ę‚―i•\2j2jBAKIN •Š—Þ‚Å‚Í48 ŽžŠÔˆČ“ā‚ÉŒŒīCr ‚Ė1.5 ”{ˆČã‚Ü‚―‚Í0.3 mg/dL ˆČã‚Ė‘‰ÁC‚Ü‚―‚Í6 ŽžŠÔ’ī‚Ė”A—ĘŒļ­iƒ0.5 mL/kg/Žžj‚ðAKI ‚Ėf’fŠî€‚Æ‚ĩ‚Ä‚Ļ‚čCŒŒīCr ‚Ė‘‰ÁC”A—ĘŒļ­‚Ė’ö“x‚É‚æ‚č3 ’iŠK‚ĖdĮ“x‚É•Š—Þ‚ģ‚ę‚éB‚ģ‚į‚ɏdĮ“x‚Í7 “úˆČ“ā‚ĖŒŒīCr ‚Ė‘‰ÁC”A—ĘŒļ­‚Å•]‰ŋ‚·‚éB

•\1@ADQI ‚É‚æ‚éAKI ‚Ėf’fŠî€iRIFLE •Š—ށj
  ŒŒīCr ‚Ü‚―‚ÍGFR ‚É‚æ‚éf’fŠî€ ”A—Ę‚É‚æ‚éf’fŠî€
Risk ŒŒīCr ãļ†ģí’l‚Ė1.5 ”{C‚Ü‚―‚ÍGFR ’ቚ„ģí’l‚Ė25“ ƒ0.5 mL/kg/Žž‚Š@6 ŽžŠÔŽ‘ą
Injury ŒŒīCr ãļ†ģí’l‚Ė2 ”{C‚Ü‚―‚ÍGFR ’ቚ„ģí’l‚Ė50“ ƒ0.5 mL/kg/Žž‚Š12 ŽžŠÔŽ‘ą
Failure ŒŒīCr ãļ†ģí’l‚Ė3 ”{C‚Ü‚―‚ÍGFR ’ቚ„ģí’l‚Ė75“C
‚Ü‚―‚Í‹}Ŧãļ≧0.5 mg/dL ‚𔚂ĪŒŒīCr≧4 mg/dL
ƒ0.3 mL/kg/Žž‚Š24 ŽžŠÔŽ‘ą
‚Ü‚―‚Í–ģ”A‚Š12 ŽžŠÔŽ‘ą
Loss t‘ã‘֗Ö@‚Š•K—v‚ȏó‘Ô‚Š4 TŠÔ’īŽ‘ą  
ESKD “§Í—Ö@‚Š3 ƒ•ŒŽ’īŽ‘ą  

Crit Care. 2004G8FR204-12.iDOI 10.1186/cc2872j©Bellomo R, et al.Glicensee BioMed Central Ltd. 2004.

•\2@AKIN ‚É‚æ‚éAKI ‚Ėf’fŠî€iAKIN •Š—ށj

ƒXƒe[ƒW

ŒŒīCr ‚É‚æ‚éf’fŠî€ ”A—Ę‚É‚æ‚éf’fŠî€

1

ŒŒīCr ãļ≧1.5`2 ”{‚Ü‚―‚Í0.3 mg/dL ƒ0.5 mL/kg/Žž‚Š6 ŽžŠÔ’īŽ‘ą

2

ŒŒīCr ãļ„2`3 ”{ ƒ0.5 mL/kg/Žž‚Š12 ŽžŠÔ’īŽ‘ą

3

ŒŒīCr ãļ„3 ”{‚Ü‚―‚Í‹}Ŧãļ0.5 mg/dL ‚ð
”š‚ĪŒŒīCr ≧4 mg/dL
ƒ0.3 mL/kg/Žž‚Š24 ŽžŠÔ’īŽ‘ąC
‚Ü‚―‚Í–ģ”A‚Š12 ŽžŠÔŽ‘ą

Crit Care. 2007G11FR31.iDOI 10.1186/cc5713j©Mehta RL, et al.Glicensee BioMed Central Ltd. 2007.

•\3@R‚Š‚ņ–ō‚É‚æ‚éAKI ‚Ė—ái‚í‚Š‘‚Å•ÛŒŊŽûÚ‚ģ‚ę‚Ä‚Ē‚éR‚Š‚ņ–ō‚Ė‚ÝŒfÚj
tŒŒŠĮ•a•Ï
  –ŅŨŠĮ˜RoĮŒóŒQ ƒCƒ“ƒ^[ƒƒCƒLƒ“2
  TMA ƒxƒoƒVƒYƒ}ƒuCƒQƒ€ƒVƒ^ƒrƒ“CƒVƒXƒvƒ‰ƒ`ƒ“Cƒ}ƒCƒgƒ}ƒCƒVƒ“CCƒCƒ“ƒ^[ƒtƒFƒƒ“
Ž…‹…‘Ė•a•Ï
  ”ũŽ•Ï‰ŧŒQ ƒCƒ“ƒ^[ƒtƒFƒƒ“CƒyƒƒgƒŒƒLƒZƒh
  ‘ƒóŽ…‹…‘Ėd‰ŧĮ ƒCƒ“ƒ^[ƒtƒFƒƒ“CƒyƒƒgƒŒƒLƒZƒhCƒ]ƒŒƒhƒƒ“Ž_
”AŨŠĮŠÔŽŋ•a•Ï
  ‹}Ŧ”AŨŠĮ‰óŽ€ ”’‹āŧÜCƒ]ƒŒƒhƒƒ“Ž_CƒCƒ“ƒ^[ƒtƒFƒƒ“Cƒyƒ“ƒgƒXƒ^ƒ`ƒ“CƒCƒ}ƒ`ƒjƒuCƒpƒ~ƒhƒƒ“Ž_
  ”AŨŠĮ‰Šiƒtƒ@ƒ“ƒRƒj[ĮŒóŒQj ƒVƒXƒvƒ‰ƒ`ƒ“CƒCƒzƒXƒtƒ@ƒ~ƒhCƒAƒUƒVƒ`ƒWƒ“CƒCƒ}ƒ`ƒjƒuCƒpƒ~ƒhƒƒ“Ž_
  ƒ}ƒOƒlƒVƒEƒ€‘rŽļ ƒVƒXƒvƒ‰ƒ`ƒ“CREGFR R‘Ė–ō
  tŦ”A•öĮ ƒVƒXƒvƒ‰ƒ`ƒ“CƒCƒzƒXƒtƒ@ƒ~ƒhCƒyƒƒgƒŒƒLƒZƒh
  R—˜”Aƒzƒ‹ƒ‚ƒ“•s“KØ•Š”åĮŒóŒQ ƒVƒNƒƒzƒXƒtƒ@ƒ~ƒhCƒrƒ“ƒNƒŠƒXƒ`ƒ“
  ‹}ŦŠÔŽŋŦt‰Š ƒ\ƒ‰ƒtƒFƒjƒuCƒXƒjƒ`ƒjƒu
  ”AŨŠĮ•ÂĮŦtáŠQ ƒƒgƒgƒŒƒLƒT[ƒg

Kidney Int. 2015G87F909-17, Clin J A Soc Nephrol. 2012G7F1713-21.©m2012nAmerican Society of Nephrology. ‚æ‚č‰ü•ÏD

② ”wŒiE–Ú“I

R‚Š‚ņ–ō‚É‚æ‚étáŠQ‚Ė•p“x‚͍‚‚­C–ōÜŦtáŠQ‚Ė15“‚ðč‚ß‚é‚Æ‚ģ‚ęCR‹Û–ōC”ņƒXƒeƒƒCƒhŦR‰ŠĮ–ō‚ÉŽŸ‚Ē‚Å•p“x‚Š‚‚Ē3jB‚Ü‚―CR‚Š‚ņ–ō‚É‚æ‚é–ōÜŦAKI ‚ā‚æ‚­’m‚į‚ę‚Ä‚Ļ‚čC“ą“ü‰ŧŠw—Ö@‚ðŽó‚Ŋ‚―537 l‚Ė‹}Ŧœ‘Ŧ”’ŒŒ•a‚ ‚é‚Ē‚͍‚ƒŠƒXƒNœ‘ˆŲŒ`ŽĮŒóŒQŠģŽŌ‚Ė‚Ī‚ŋ36“‚ÉAKI ‚Š”­Į‚ĩC‚ģ‚į‚ÉESRD‚ÉŽŠ‚Á‚―Į—á‚Å‚ÍŽ€–S—Ķ‚Š61.7“‚Å‚ ‚Á‚―4jB‚ģ‚į‚É•Ę‚Ė•ņ‚ł́CAKI ‚ð‡•đ‚ĩ‚―‚Š‚ņŠģŽŌ‚ĖŽ€–S—Ķ‚Í73“‚Æ‚Ŧ‚í‚߂č‚‚Ē‚ą‚Æ‚Š•ņ‚ģ‚ę‚Ä‚Ē‚é5jBR‚Š‚ņ–ō‚É‚æ‚éAKI ‚́CCKD ‚âESRD ‚ĖƒŠƒXƒN‚Š‘‚·‚ū‚Ŋ‚Å‚Č‚­Ct‹@”\’ቚ‚É‚æ‚čR‚Š‚ņ–ō“Š—^—p—Ę’ēß‚Š•K—v‚É‚Č‚čC–Ú‘O‚É”—‚Á‚―ŽŸ‚ĖR‚Š‚ņ–ō“Š—^‚ÉŽxá‚ð‚Ŧ‚―‚·‚ą‚Æ‚ā–â‘č‚Æ‚Č‚éB”‘―‚­‚Ė‰ŧŠw—Ö@‚ĖƒŒƒWƒƒ“‚Š‘ķÝ‚·‚é‚―‚߁CAKI ‚ā‘―—l‚Č—Õ°Įó‚ð’æ‚·‚éBR‚Š‚ņ–ō‚É‚æ‚éAKI ‚Ė—á‚ð•\3 ‚ÉŽĶ‚·6, 7jB”AŨŠĮáŠQ‚Æ‚ĩ‚Ä‘ã•\“I‚Č–ōÜ‚Í”’‹āŧÜ‚Å‚ ‚čC‚Ļ‚ā‚ȏáŠQ•”ˆĘ‚Í”AŨŠĮŠÔŽŋ‚Å‚ ‚éB‚―‚Æ‚Ķ‚΁CƒVƒXƒvƒ‰ƒ`ƒ“‚Å‚Í–ņ1/3 ‚ĖŠģŽŌ‚ŠAKI ‚ð‚Ŧ‚―‚·‚ą‚Æ‚Š’m‚į‚ę‚Ä‚Ē‚é8jBŒŒŠĮáŠQ‚Æ‚ĩ‚Ă͍RVEGF R‘Ė‚Å‚ ‚éƒxƒoƒVƒYƒ}ƒu‚Š—L–ž‚Å‚ ‚čCTMA ‚ð—U”­‚·‚éB

ŒŒīCr ‚Æ”A—Ę‚ÉŠî‚ÂĒ‚―RIFLE •Š—Þ‚âAKIN •Š—Þ‚Ė“oę‚́CAKI ‚Ėf’f‚ð‘å‚Ŧ‚­‘Oi‚ģ‚đ‚―‚ŠC‚Ē‚Ü‚ū–â‘č“_‚Í‘―‚ĒBŒŒīCr ‚Í”N—î‚â‘ĖdCŦ·C–ōÜC‹Ø“ũ‘ãŽÓCƒ^ƒ“ƒpƒNÛŽæC‘Ė‰t‰ßč‚Ė‰e‹ŋ‚ðŽó‚Ŋ‚é‚Č‚ĮCAKI ‚Ėƒ}[ƒJ[‚Æ‚ĩ‚Ä‘―‚­‚ĖŒ‡“_‚ð—L‚·‚é9, 10jB‚ģ‚į‚ɁCŒŒīCr ‚͍ŏ‰‚ɐtáŠQ‚ðŽó‚Ŋ‚Ä‚Đ‚įãļ‚·‚é‚Ü‚Å48`72 ŽžŠÔ‚Đ‚Đ‚é‚Æ‚ģ‚ę‚Ä‚Ļ‚čCv‘Ž‚ČAKI ‚Ėf’f‚Ļ‚æ‚ŅŽĄ—Éî“ü‚ð–W‚°‚é—vˆö‚Ėˆę‚Â‚Æ‚Č‚Á‚Ä‚Ē‚é10jBŒŒīCr ‚ĖŒ‡“_‚ð•â‚Ī‚―‚߁CAKI ‚ɑ΂·‚é‘―‚­‚ĖV‚ĩ‚ĒƒoƒCƒIƒ}[ƒJ[‚Ė—L—pŦ‚ŠŒŸ“Ē‚ģ‚ę‚Ä‚Ŧ‚―B‚ĩ‚Đ‚ĩCAKI ‚ĖV‹KƒoƒCƒIƒ}[ƒJ[‚Š—Տ°‚ÅŽg‚Ķ‚é‚æ‚Ī‚É‚Č‚é‚ɂ́CŦ·C”N—CŒīŽūŠģ‚ɉž‚ķ‚―臒l‚ĖÝ’č‚Š•K{‚Å‚ ‚čC‚Ē‚Ü‚ūƒn[ƒhƒ‹‚Š‚‚Ē11jB

–{e‚Ė–Ú“I‚́CR‚Š‚ņ–ō‚É‹Nˆö‚·‚éAKI ‚ɑ΂·‚éƒoƒCƒIƒ}[ƒJ[‚ĖÅV’mŒĐ‚ðŒŸ“Ē‚ĩCŽĀÛ‚Ė—Տ°‚É‚Ļ‚Ŋ‚é‚ŧ‚Ė—L—pŦ‚ÆŒĀŠE‚ð–ū‚į‚Đ‚É‚·‚é‚ą‚Æ‚Å‚ ‚éB

‰ð@ā

–{e‚Å‚ĖƒoƒCƒIƒ}[ƒJ[‚Ƃ́C‹qŠÏ“I‚Č•]‰ŋ‚Š‰Â”\‚ŁCķ—Šw“I‚ ‚é‚Ē‚Í•a—Šw“I•Ï‰ŧC‚Ļ‚æ‚ŅŽĄ—Éî“ü‚ɑ΂·‚é–ō—Šw“I”―‰ž‚ĖŽw•W‚Æ‚Č‚é‚ā‚Ė‚Å‚ ‚é12jBR‚Š‚ņ–ō‚É‹Nˆö‚·‚éAKI ‚ɑ΂·‚éƒoƒCƒIƒ}[ƒJ[‚ĖðŒ‚Í‚Š‚ņ‚ɑ΂·‚é‚Ē‚ЂȂ鎥—Ã‚Đ‚į‚ĖŠąÂ‚āŽó‚Ŋ‚Č‚Ē‚ą‚Æ‚Å‚ ‚čC–ðŠ„‚Æ‚ĩ‚Ä‚Í①ƒŠƒXƒN•]‰ŋC②‘Šúf’fC③•aŠú•Š—ށC④ŠÓ•Ęf’fC⑤ŽĄ—ÃŒø‰ĘŽw•WC⑥—\Œã”ŧ’čC‚Šl‚Ķ‚į‚ę‚éB‚Æ‚­‚ÉŒŒīCr ‚âeGFR ‚Æ‚­‚į‚Ũ‚Ä‘Šú‚Ėf’f‚Š‰Â”\‚ČƒoƒCƒIƒ}[ƒJ[‚ĖŽĀ—p‰ŧ‚ŠŠú‘Ō‚ģ‚ę‚éB

–{e‚ł́C‚í‚Š‘‚É‚Ļ‚Ŋ‚éŽĀ—Տ°‚É‚Ļ‚Ē‚Ä•ÛŒŊf—ÂŎg—p‰Â”\‚ČƒoƒCƒIƒ}[ƒJ[‚ƁCŽĀ—Տ°‚ÅŽg—p‚Å‚Ŧ‚Č‚Ē‚ā‚Ė‚ð‚í‚Ŋ‚Ä‹LÚ‚ĩ‚―B‚Ü‚―C2010 ”N‚ɈĀ‘SŦ—\‘ŠŽŽŒąƒRƒ“ƒ\[ƒVƒAƒ€iPredictive Safety Testing ConsortiummPSTCnj‚Ėt“ŐŦė‹Æ•”‰ï‚ŠC–ō•Ļ‚Ė“ŐŦŽŽŒą‚Ļ‚æ‚ŅƒoƒCƒIƒ}[ƒJ[Ŧ”\•ŠÍ‚ĖŒ‹‰Ę‚ðFDA ‚ƉĒBˆã–ō•iRļ’ĄiEuropean Medicines Evaluation AgencymEMEAnj‚É’ņo‚ĩC‚ŧ‚Ė‚Č‚Đ‚ÅKidney Injury Molecule-1iKim-1jC”A’†ƒAƒ‹ƒuƒ~ƒ“C”Aƒ^ƒ“ƒpƒNCƒĀ2ƒ~ƒNƒƒOƒƒuƒŠƒ“CŒŒīƒVƒXƒ^ƒ`ƒ“CCƒNƒ‰ƒXƒeƒŠƒ“Ctrefoil factor 3iTFF-3j‚Št‹@”\‚ĖˆĀ‘SŦ‚ÉŠÖ‚·‚éƒoƒCƒIƒ}[ƒJ[‚Æ‚ĩ‚Ä‚ ‚°‚į‚ę‚Ä‚Ē‚é13jB‚ą‚Ė•ņ‚Å‚Í‚ ‚­‚܂ňĀ‘SŦ•]‰ŋ‚Ė–Ú“I‚ÉŒĀ’č‚ģ‚ę‚Ä‚Ē‚é‚ŠC‚ą‚ĖŽĩ‚‚ɂ‚Ē‚Ă͍R‚Š‚ņ–ō‚É‹Nˆö‚·‚éAKI ‚ɑ΂·‚éƒoƒCƒIƒ}[ƒJ[‚Æ‚ĩ‚Ä‚Ė—L—pŦ‚ɂ‚Ē‚Ä–{e‚Ř_‚ķ‚é•K—v‚Š‚ ‚é‚ƍl‚Ķ‚―B

1D•ÛŒŊf—ÂőŠ’č‰Â”\‚ČƒoƒCƒIƒ}[ƒJ[
aj”A’†ƒAƒ‹ƒuƒ~ƒ“

”A’†ƒAƒ‹ƒuƒ~ƒ“‚ÍŽ…‹…‘Ė“§‰ßŦ˜īi‚â‹ßˆĘ”AŨŠĮÄ‹zŽûáŠQ‚É‚æ‚č‘‰Á‚·‚éBŽĀÛC’ZŠúŠÔ‚ ‚é‚Ē‚Í’·ŠúŠÔ‚Ėt“ŐŦR‚Š‚ņ–ō‚Ė“Š—^‚É‚æ‚čC”A’†”ũ—ĘƒAƒ‹ƒuƒ~ƒ“‚Š‘‰Á‚·‚é‚ą‚Æ‚Š•ņ‚ģ‚ę‚Ä‚Ē‚é14jB‚ĩ‚Đ‚ĩCAKI ˆČŠO‚É‚ā”­”M‚â‰^“ŪC’E…C“œ”A•aC‚ŒŒˆģ‚Č‚Į‚Å‚ā‘‰Á‚·‚é‚ą‚Æ‚Š’m‚į‚ę‚Ä‚Ļ‚čCAKI ‚ĖƒoƒCƒIƒ}[ƒJ[‚Æ‚ĩ‚Ä‚Ė“ÁˆŲ“x‚ÍŒĀ’č“I‚ƍl‚Ķ‚į‚ę‚Ä‚Ē‚é15jB

bj”Aƒ^ƒ“ƒpƒN

Ž…‹…‘ĖáŠQ‚ĖŒŸo‚É‚Ļ‚Ē‚Ä‚Í”Aƒ^ƒ“ƒpƒN‚ŠBUN ‚Ļ‚æ‚ŅŒŒīCr ‚æ‚č‚āf’f”\‚Šã‰ņ‚é‚Æ‚Ē‚í‚ę‚Ä‚Ē‚é‚Š16jCAKI ‚ĖƒoƒCƒIƒ}[ƒJ[‚Æ‚ĩ‚Ä‚Í“ÁˆŲŦ‚Š’á‚Ē‚ą‚Æ‚ā•ņ‚ģ‚ę‚Ä‚Ļ‚č17jC‚ŧ‚Ė—L—pŦ‚ÍŠm—§‚ĩ‚Ä‚Ē‚Č‚ĒB

cjŒŒīƒVƒXƒ^ƒ`ƒ“C

ƒVƒXƒ^ƒ`ƒ“‚̓qƒg‚Ė‘Ė“ā‚Å‚ā‚Á‚Æ‚ād—v‚ČƒVƒXƒeƒCƒ“ƒvƒƒeƒA[ƒ[‘jŠQ•ĻŽŋ‚Å‚ ‚éBƒVƒXƒ^ƒ`ƒ“C ‚Í13 kDa ‚Ėƒ^ƒ“ƒpƒN‚ŁC‚·‚Ũ‚Ä‚Ė—LŠjŨ–E‚Đ‚į•Š”å‚ģ‚ę‚é‚ŠCŒŒŸũƒ^ƒ“ƒpƒN‚ÆŒ‹‡‚ĩ‚Č‚Ē‚Æ‚Ē‚Ī“Á’Ĩ‚Š‚ ‚éB‚ŧ‚ę‚ä‚Ķ‚ɐtŽ…‹…‘Ė‚Å‚ÍŽĐ—R‚Éāh‰ß‚ģ‚ęC‹ßˆĘ”AŨŠĮ‚ōċzŽûŒãCŽ–E‘ĖŽó—e‘Ė‚Å‚ ‚郁ƒKƒŠƒ“‚É‚æ‚Á‚Ä99“ˆČã‚Š•Š‰ð‚ģ‚ę‚é18jBCr ‚Ƃ͈Ų‚Č‚čƒVƒXƒ^ƒ`ƒ“C ‚Í”AŨŠĮ‚Đ‚į”A’†‚É•Š”å‚ģ‚ę‚ļCŦ•ĘE‹Ø“ũ—Ę‚ÉˆË‘ķ‚ĩ‚Č‚ĒBŒy“x`’†“™“xtáŠQŠģŽŌ‚Å‚āŒŒīƒVƒXƒ^ƒ`ƒ“C ‚ÍGFR ‚Æ‚æ‚­‘ŠŠÖ‚·‚é‚―‚ß19jCŒŒīCr ‚æ‚č‚ā‘ŠútáŠQ‚ðŠī“x‚æ‚­‘Ļ‚Ķ‚é‚ą‚Æ‚Š‰Â”\‚Å‚ ‚čCŒŒīƒVƒXƒ^ƒ`ƒ“C ‚ÍAKI ‚Ė—L—p‚Čƒ}[ƒJ[‚Æ‚Ē‚í‚ę‚Ä‚Ē‚é20jB‚ĩ‚Đ‚ĩCŒŒīƒVƒXƒ^ƒ`ƒ“C ‚Í①“œ”A•a‚â‘―—Ę‚ĖƒRƒ‹ƒ`ƒRƒXƒeƒƒCƒhCbó‘B‹@”\˜īiĮC‰ŠĮC‚ƒrƒŠƒ‹ƒrƒ“ŒŒĮC‚ƒgƒŠƒOƒŠƒZƒ‰ƒCƒhŒŒĮ‚Ė‰e‹ŋ‚ðŽó‚Ŋ‚é21jC②GFRƒ15 mL/•Š/1.73 m2‚É’B‚·‚é‚Əãļ‚ÍŠÉ–‚É‚Č‚čC5`6 mg/L ’ö“x‚ʼnĄ‚΂Ē‚É‚Č‚é22jC‚Æ‚Ē‚Á‚―ŒĀŠE‚Š‚ ‚éBBenöhr ‚į23j‚̓VƒXƒvƒ‰ƒ`ƒ““Š—^3 “ú‘O‚Æ‚­‚į‚Ũ‚Ä5 “úŒã‚Å‚Í—LˆÓ‚ÉŒŒīƒVƒXƒ^ƒ`ƒ“C‚Šãļ‚ĩ‚Ä‚Ē‚é‚ą‚Æ‚ðŽĶ‚ĩ‚―BŒŧó‚ōR‚Š‚ņ–ō“Š—^‚É‹Nˆö‚·‚éAKI ‚ɑ΂·‚éƒoƒCƒIƒ}[ƒJ[‚Æ‚ĩ‚Ä‚Ė—L—pŦ‚ÍŠm—§‚ģ‚ę‚Ä‚Ē‚Č‚ĒBŒŒīƒVƒXƒ^ƒ`ƒ“C ‚Ė‘Š’č‚Í•ÛŒŊ“K—p‚ū‚ŠC”A’†ƒVƒXƒ^ƒ`ƒ“C ‚Ė‘Š’č‚É“K—p‚Í‚Č‚ĒB

djƒĀ2ƒ~ƒNƒƒOƒƒuƒŠƒ“

ƒĀ2ƒ~ƒNƒƒOƒƒuƒŠƒ“‚Í•ŠŽq—Ę11,800CƒAƒ~ƒmŽ_99 ŒÂ‚Đ‚į‚Č‚éƒ|ƒŠƒyƒvƒ`ƒh‚ŁCŽå—v‘gD“K‡ŦRŒī‚Å‚ ‚éHLA ƒNƒ‰ƒX‡TRŒī‚ĖL ―‚Æ‚ĩ‚Ä‘Sg‚Ė—LŠjŨ–E•\–Ę‚É•Š•z‚·‚éBŽ…‹…‘ĖŠî’ę–Œ‚ðŽĐ—R‚ɒʉ߂ĩ‚āC‚Ų‚Æ‚ņ‚Į‚Í‹ßˆĘ”AŨŠĮ‚ōċzŽû‚ģ‚ę‚é‚ŠC”AŨŠĮáŠQ‚ł͍ċzŽû‚Š’ቚ‚ĩ”A’†‚Ö‚Ė”rŸ•‚Š‘‰Á‚·‚é‚―‚߁CAKI ‚Ėƒ}[ƒJ[‚Æ‚ĩ‚Ä‚Ė—L—pŦ‚ŠŠú‘Ō‚ģ‚ę‚Ä‚Ē‚éBŽĀÛ‚ɁC”AŨŠĮáŠQŽž‚É‚ÍŒŒīCr ‚æ‚č‚ā4`5 “ú‘‚­”A’†ƒĀ2ƒ~ƒNƒƒOƒƒuƒŠƒ“‚Šãļ‚·‚é‚ą‚Æ‚Š•ņ‚ģ‚ę‚Ä‚Ē‚é24jB‚ĩ‚Đ‚ĩCŽ_Ŧ”A’†‚⎚‰·‚Å‚Í‚Ŧ‚í‚ß‚Ä•sˆĀ’č‚Å‚ ‚é‚Æ‚Ē‚ĪŒ‡“_‚Š‚ ‚čCƒoƒCƒIƒ}[ƒJ[‚Æ‚ĩ‚Ä‚ĖŒĀŠE‚āŽw“E‚ģ‚ę‚Ä‚Ē‚é25jB

ejNAG

t‚É‚Ļ‚Ē‚ÄNAG ‚̓‰ƒCƒ\ƒ][ƒ€‚É‘ķÝ‚·‚é“œŽŋ•Š‰ðy‘f‚Å‚ ‚čC‹ßˆĘ”AŨŠĮŨ–E‚ĖŽ–E‘Ė‚ÅŽYķ‚ģ‚ę‚éB”AŨŠĮáŠQ‚É‚æ‚č”A’†‚Ö‚Ė”rŸ•‚Š‘‰Á‚·‚é‚―‚߁C”A’†NAG ‚āAKI ‚Ė—L—p‚Čƒ}[ƒJ[‚Æ‚ĩ‚Ä•ņ‚ģ‚ęCŒŒŸũCr ‚æ‚č‚ā12 ŽžŠÔ`4 “ú‘‚­ˆŲí’l‚ðŽĶ‚·‚Æ•ņ‚ģ‚ę‚―26jBGoren ‚į27j‚Í12 —á‚ŃVƒXƒvƒ‰ƒ`ƒ““Š—^‘OŒã‚ĖNAG —Ę‚ð”äŠr‚ĩ‚Ä‚Ē‚éB”Þ‚į‚ĖŒŸ“Ē‚ł́CƒVƒXƒvƒ‰ƒ`ƒ““Š—^ŒãNAG —Ę‚Íãļ‚ĩC3 “ú–ڂɍō‚’l‚Æ‚Č‚č‚ŧ‚ĖŒã’ቚ‚ĩ‚―BIkeda ‚į28j‚̓VƒXƒvƒ‰ƒ`ƒ““Š—^Œã‚ĖNAG‚ƃĀ2ƒ~ƒNƒƒOƒƒuƒŠƒ“‚ð8 —á‚ÅŒŸ“Ē‚ĩ‚―BƒĀ2ƒ~ƒNƒƒOƒƒuƒŠƒ“‚Í“Š—^3 “ú–ڂōō‚’l‚Æ‚Č‚č1 TŠÔ‚Å‘O’l‚܂Œቚ‚ĩ‚―‚Ė‚ɑ΂ĩ‚āCNAG ‚Í“Š—^2 TŠÔŒã‚Ü‚Å‘‰Á‚·‚éĮ—á‚Š‚ ‚Á‚―‚ą‚Æ‚ð•ņ‚ĩ‚Ä‚Ē‚éB‚ĩ‚Đ‚ĩC”A’†NAG ‚Í‘―‚­‚Ėt“ŐŦ•ĻŽŋ‚âƒ}ƒOƒlƒVƒEƒ€C“āˆöŦ”A‘f29j‚ÉŠˆŦ‚Š—}§‚ģ‚ę‚é‚Æ‚Ē‚ĪŒ‡“_‚Š‚ ‚éB‚ģ‚į‚ÉAKI ˆČŠO‚Å‚āŠÖßƒŠƒEƒ}ƒ`30j‚â‘Ï“œ”\ˆŲí31jCbó‘B‹@”\˜īiĮ32j‚Å‚ā”A’†NAG ‚͍‚’l‚Æ‚Č‚é‚―‚߁CAKI ‚ɑ΂·‚é“ÁˆŲŦ‚Í’á‚Ē‚Æ‚Ē‚í‚ę‚Ä‚Ē‚éB

fj”A’†L-FABP

L-FABP ‚͐t‚É‚Ļ‚Ē‚Ä‹ßˆĘ”AŨŠĮ‚É”­Œŧ‚·‚鎉–bŽ_‚Ė—A‘—ƒ^ƒ“ƒpƒN‚Å‚ ‚čC‚ģ‚į‚ɍRŽ_‰ŧė—p‚ā—L‚·‚é33jBƒqƒgL-FABP ‚Íhypoxia-inducible factor 1a ‰ž“š”z—ņ‚ð‚ā‚‚―‚ßL-FABP ‚Ė”­Œŧ‚Í’áŽ_‘f‚É‚æ‚Á‚Ä—U“ą‚ģ‚ę‚é34jB”AŨŠĮáŠQ‚Å”A’†‚Ö‚Ė”rŸ•‚Š‘‰Á‚·‚é‚ą‚Æ‚Š’m‚į‚ę‚Ä‚Ļ‚čCS‘ŸŒŒŠĮŽčpŒã‚ÉAKI ‚Æ‚Č‚Á‚―Į—á‚ł́CŽčp’žŒã‚Đ‚į”A’†L-FABP ‚Ė‘‰Á‚Š”F‚ß‚į‚ę35jC”A’†L-FABP ‚’l‚ÍAKI ‚Ė“Æ—§‚ĩ‚―—\‘ŠˆöŽq‚Å‚ ‚é‚Æ•ņ‚ģ‚ę‚Ä‚Ē‚é36jBAKI ‚ɑ΂·‚éƒoƒCƒIƒ}[ƒJ[‚Æ‚ĩ‚āCL-FABP ‚ÍKim-1CNGALCNAG ‚Æ“Ŋ“™‚Å‚ ‚é‚ą‚Æ‚ŠŽĶ‚ģ‚ę37jC‚í‚Š‘‚Å‚ÍL-FABP ‚ŠAKI f’f‚ɑ΂ĩ‚Ä•ÛŒŊ“K—p‚ģ‚ę‚Ä‚Ē‚éB‚ĩ‚Đ‚ĩCR‚Š‚ņ–ō“Š—^‚É‹Nˆö‚·‚éAKI ‚ɑ΂·‚éƒoƒCƒIƒ}[ƒJ[‚Æ‚ĩ‚Ä‚Ė—L—pŦ‚̓qƒg‚É‚Ļ‚Ē‚Ä‚Ų‚Æ‚ņ‚ĮŒŸØ‚ģ‚ę‚Ä‚Ļ‚į‚ļCĄŒã‚ĖŒŸ“Ē‚Š•K—v‚Å‚ ‚éB

2D•ÛŒŊf—ÂőŠ’č‚Å‚Ŧ‚Č‚ĒƒoƒCƒIƒ}[ƒJ[
aj”A’†Kim-1

Kim-1 ‚͍Ũ–E–ŒŠŅ’ĘŒ^“œƒ^ƒ“ƒpƒN‚ŁCtáŠQŽž‚É‹ßˆĘ”AŨŠĮŨ–E‚ÅŽYķ‚ģ‚ęCt‹•ŒŒŒã12 ŽžŠÔ‚ōŨ–EŠOƒhƒƒCƒ“•”•Š‚Ė”A’†‚Ö‚Ė”rŸ•‚Š‘‰Á‚·‚é38jBƒVƒXƒvƒ‰ƒ`ƒ“‚É‚æ‚ét“ŐŦƒ‚ƒfƒ‹“Ū•Ļ‚Å‚ÍŒŒīCr ‚æ‚č‚ā‘‚­Kim-1 ‚Šãļ‚·‚é‚ą‚Æ‚Đ‚įC”AŨŠĮáŠQ‚ĖƒoƒCƒIƒ}[ƒJ[‚Æ‚ĩ‚Ä—L—p‚Æ•ņ‚ģ‚ę‚―39jB‚ģ‚į‚ɃVƒXƒeƒ}ƒeƒBƒbƒNƒŒƒrƒ…[‚ł́CKim-1 ‚͐táŠQŒã24 ŽžŠÔˆČ“ā‚É•Ï“Ū‚·‚éƒoƒCƒIƒ}[ƒJ[‚Å‚ ‚é‚Æ•ņ‚ģ‚ę‚―40jBKim-1 ‚͕č‘FDA ‚Đ‚įAKI ‚Ėƒ}[ƒJ[‚Æ‚ĩ‚ďģ”F‚ģ‚ę‚Ä‚Ē‚éBTekce ‚į41j‚ÍeGFR†90 mL/•Š‚Ė22 —á‚É‚Ļ‚Ŋ‚éƒVƒXƒvƒ‰ƒ`ƒ““Š—^Œã‚ĖAKI 8 —áC”ņAKI Į—á14 —á‚ŁCŒŒīKim-1 ‚Æ”A’†Kim-1 ‚ðƒVƒXƒvƒ‰ƒ`ƒ““Š—^‘OC“Š—^1C3C5 “úŒã‚Å”äŠr‚ĩ‚―B“Š—^1 “úŒã‚Å‚ÍŒŒīCrCeGFRCŒŒīKim-1 ‚É—žŒQŠÔ‚Ė·‚Í‚Č‚Đ‚Á‚―‚ŠC”A’†Kim-1 ‚ÍAKI ŒQ‚Ė‚Ų‚Ī‚Š—LˆÓ‚ɍ‚’l‚Å‚ ‚Á‚―B3 “úŒã‚É‚ÍŒŒīCrCeGFRC”A’†Kim-1 ‚Š—žŒQ‚Å—LˆÓ‚ȍ·‚ð”F‚ß‚―‚ŠCŒŒīKim-1 ‚Í—LˆÓ‚ȍ·‚ð”F‚ß‚Č‚Đ‚Á‚―B‚ĩ‚―‚Š‚Á‚āC”A’†Kim-1 ‚̓VƒXƒvƒ‰ƒ`ƒ“‚É‚æ‚éAKI ‚Ė‘Šúƒ}[ƒJ[‚Æ‚ĩ‚ÄŠú‘Ō‚ģ‚ę‚Ä‚Ē‚éB‚ĩ‚Đ‚ĩC”A’†‚ÅKim-1 ‚ĖˆĀ’čŦ‚Š’˜‚ĩ‚­’ቚ‚·‚é‚Æ‚Ė•ņ‚ā‚ ‚čC‚ģ‚į‚ÉŒŸ“Ē‚ð—v‚·‚é‚Æ‚Ē‚í‚ę‚Ä‚Ē‚é42jB

bjNGAL

Neutrophil gelatinase-associated lipocaliniNGALj‚Í25 kDa ‚Ė“œƒ^ƒ“ƒpƒN‚Å‚ ‚čC‚Ļ‚ā‚ÉŠˆŦ‰ŧ‚ģ‚ę‚―D’†‹…‚Đ‚į•Š”å‚ģ‚ęCģíŽž‚Í‹ßˆĘ”AŨŠĮ‚Å100“Ä‹zŽû‚ģ‚ę‚éB”AŨŠĮáŠQŽž‚ɂ̓wƒ“ƒŒãs‹r‚Æˆę•”‚ĖW‡ŠĮ‚É”­Œŧ‚ĩCŒŒ’†C”A’†‚Ö‚Ė”rŸ•‚Š‘‰Á‚·‚é‚―‚߁CAKI Œã2`4 ŽžŠÔ‚ňŲí’l‚ðŽĶ‚·‚Æ‚ģ‚ę‚éB2,500 —á‚ð’ī‚Ķ‚éĮ—á‚ðW‚ß‚―ƒƒ^‰ðÍ‚ĖŒ‹‰Ę‚Đ‚įCNGAL ‚ÍAKI ‚Ėf’f‚ū‚Ŋ‚Å‚Č‚­Ct—\Œã‚ɂ‚Ē‚Ä‚ā—L—p‚Čƒ}[ƒJ[‚Æ‚Ē‚í‚ę‚Ä‚Ē‚é43jBPeres ‚į44j‚̓VƒXƒvƒ‰ƒ`ƒ““Š—^ŒãAKI ŒQ‚Ė‚Ų‚Ī‚Š”ņAKI ŒQ‚Æ”äŠr‚ĩ‚ÄNGAL ‚͍‚’l‚Å‚ ‚Á‚―‚ŠC—LˆÓ·‚Í‚Č‚Đ‚Á‚―‚Æ•ņ‚ĩ‚―B‚Ü‚―Gaspari ‚į45j‚̓VƒXƒvƒ‰ƒ`ƒ““Š—^Œã1C4 ŽžŠÔŒãC‚Ļ‚æ‚Ņ1C2C3C7C15 “úŒã‚ĖNGAL ‚ð12 —á‚ĖAKI ŒQ‚Æ12 —á‚Ė”ņAKI ŒQ‚Å”äŠr‚ĩ‚―BŒŒīCr ‚̓VƒXƒvƒ‰ƒ`ƒ““Š—^Œã3 “ú–Ú‚Đ‚įAKI ŒQ‚Æ”ņAKI ŒQ‚Å—LˆÓ·‚ð”F‚ß‚―‚Ė‚ɑ΂ĩ‚āCNGAL ‚Í1 “úŒã‚æ‚č—LˆÓ·‚ð”F‚ß‚―B‚ĩ‚―‚Š‚Á‚āCNGAL ‚ÍŒŒīCr ‚æ‚葁Šú‚ɃVƒXƒvƒ‰ƒ`ƒ“‚É‚æ‚éAKI ‚ðf’f‚Å‚Ŧ‚éƒoƒCƒIƒ}[ƒJ[‚Æ‚ĩ‚Ä‚Ė‰Â”\Ŧ‚Š‚ ‚éB

cjƒNƒ‰ƒXƒeƒŠƒ“

ƒNƒ‰ƒXƒeƒŠƒ“‚Í76`80 kDa ‚Ė“œƒ^ƒ“ƒpƒN‚ŁCtáŠQŽž‚ɂ͍RƒAƒ|ƒg[ƒVƒXė—p‚É‚æ‚ét•ÛŒėė—p‚Š‚ ‚é‚ā‚Ė‚Æ‘z’č‚ģ‚ę‚Ä‚Ē‚éB‹ßˆĘ”AŨŠĮáŠQ‚ĖŒŸo‚ł́C”A’†ƒNƒ‰ƒXƒeƒŠƒ“‚ŠBUN ‚Ļ‚æ‚ŅŒŒīCr ‚æ‚č—D‚ę‚Ä‚Ē‚é‚ą‚Æ‚Š•ņ‚ģ‚ę‚―16jB‚ĩ‚Đ‚ĩƒqƒg‚ĖAKI ‚ɑ΂·‚錟“Ē‚Í•s\•Š‚Å‚ ‚čC‚ģ‚į‚ɍR‚Š‚ņ–ō‚É‚æ‚éAKI ‚ĖƒoƒCƒIƒ}[ƒJ[‚Æ‚Č‚é‚Đ‚Į‚Ī‚Đ‚Í•s–ū‚Å‚ ‚éB

dj”A’†TFF-3

TEF-3 ‚ÍAKI ‚Å‚Í”A’†”rŸ•‚ŠŒļ­‚·‚éB”A’†TFF-3 ‚̓‚ƒfƒ‹“Ū•Ļ‚ĖŒŸ“Ē‚É‚Ļ‚Ē‚ÄAKI ‚Ė—L—p‚Čƒ}[ƒJ[‚Å‚ ‚é‚ą‚Æ‚ŠŽĶ‚ģ‚ę‚Ä‚Ē‚é‚ŠCƒqƒg‚ɑ΂·‚錟“Ē‚Í•s\•Š‚Å‚ ‚é46jB

ejƒGƒ“ƒhƒZƒŠƒ“1

ƒGƒ“ƒhƒZƒŠƒ“1 ‚ÍŒŒŠĮŽûkė—p‚ð—L‚ĩC21 ŒÂ‚ĖƒAƒ~ƒmŽ_‚Đ‚į‚Č‚čCt‚ł̓ƒTƒ“ƒMƒEƒ€Ũ–E‚âW‡ŠĮ‚É”­Œŧ‚·‚éBTakeda ‚į47j‚Í”A’†ƒGƒ“ƒhƒZƒŠƒ“1 —l–ƉuŠˆŦ/Cr ‚ðƒVƒXƒvƒ‰ƒ`ƒ““Š—^‘OC“Š—^1C2 TŠÔŒã‚É‘Š’č‚ĩC“Š—^‘O‚Æ‚­‚į‚Ũ‚Ä“Š—^1C2 TŠÔŒã‚É—LˆÓ‚ɏãļ‚·‚é‚ą‚Æ‚ð•ņ‚ĩ‚―BƒVƒXƒvƒ‰ƒ`ƒ““Š—^ŒãCƒĀ2ƒ~ƒNƒƒOƒƒuƒŠƒ“/Cr ‚ƃGƒ“ƒhƒZƒŠƒ“1 —l–ƉuŠˆŦ/Cr ‚Í2 “ú–ڂɃs[ƒN‚É’B‚ĩC‚ŧ‚ĖŒã’ቚ‚ĩ‚―‚ŠCNAG/Cr ‚Ėƒs[ƒN‚Í6 “ú–Ú‚Å‚ ‚Á‚―B

ãqˆČŠO‚É‚āCƒCƒ“ƒ^[ƒƒCƒLƒ“18CƒAƒ“ƒWƒIƒeƒ“ƒVƒm[ƒQƒ“Ctissue inhibitor of metalloproteinase-2CƒCƒ“ƒXƒŠƒ“—lŽ’·ˆöŽqiIGFj-binding protein 7 ‚Č‚Į‚ŠCAKI ‚ɑ΂·‚éƒoƒCƒIƒ}[ƒJ[‚Æ‚ĩ‚Ä‚Ė—L—pŦ‚ðŒŸ“Ē‚ģ‚ę‚Ä‚Ē‚é33jB

‚ą‚Ė‚æ‚Ī‚ɁCƒ‚ƒfƒ‹“Ū•Ļ‚ɑ΂·‚錟“Ē‚Å‚Í‚ģ‚Ü‚ī‚Ü‚ČƒoƒCƒIƒ}[ƒJ[‚Ė—L—pŦ‚Š•ņ‚ģ‚ę‚Ä‚Ē‚é‚Š48jCƒqƒg‚ɑ΂ĩ‚Ä‚Í‚Ŧ‚í‚߂ăGƒrƒfƒ“ƒX‚É–R‚ĩ‚ĒB‚ŧ‚ĖŒīˆö‚Æ‚ĩ‚āC①AKI ‚Ėf’fŠî€‚Š“ˆę‚ģ‚ę‚Ä‚Ē‚Č‚Đ‚Á‚―‚―‚߁C•ņ‚É‚æ‚č·ˆŲ‚Š‚ ‚é‚ą‚ƁC②AKI ‘S‘Ė‚ðŒŸ“Ē‚ĩ‚―•ņ‚͐”‘―‚­‘ķÝ‚·‚é‚ŠCR‚Š‚ņ–ō‚É‚æ‚éAKI ‚ÉŒĀ‚Á‚Ä•]‰ŋ‚ĩ‚―•ņ‚Í‚Ŧ‚í‚߂ď­‚Č‚Ē‚ą‚ƁC③‘―‚­‚ĖƒoƒCƒIƒ}[ƒJ[‚Å‚Í–ū‚į‚Đ‚Č臒l‚ŠÝ’č‚Å‚Ŧ‚Ä‚Ē‚Č‚Ē‚―‚߁CŒÂX‚ĖŒĪ‹†‚Å‚Ė•]‰ŋ‚ŠĒ“ï‚Å‚ ‚é‚ą‚ƁC④R‚Š‚ņ–ōŽĄ—Â͑―Ü•đ—p‚ōs‚í‚ę‚é‚ą‚Æ‚Š‘―‚­C‚ģ‚į‚É‚ŧ‚ę‚ž‚ę‚ĖR‚Š‚ņ–ō‚É‚æ‚čtáŠQ‚ĖƒƒJƒjƒYƒ€‚ŠˆŲ‚Č‚čC•Ą”‚ĖƒƒJƒjƒYƒ€‚Š‘z’č‚ģ‚ę‚éR‚Š‚ņ–ō‚ā‚ ‚é‚―‚߁iƒVƒXƒvƒ‰ƒ`ƒ“‚Č‚ĮjC’Pˆę‚ĖƒoƒCƒIƒ}[ƒJ[‚Å•]‰ŋ‚·‚é‚ą‚Æ‚Ė‘Ó–Ŧ‚Š•s–ū‚Å‚ ‚é‚ą‚ƁiŽ–ŽĀC•Ą”‚ĖƒoƒCƒIƒ}[ƒJ[‚ð‘g‚ݍ‡‚í‚đ‚é‚ą‚Æ‚Ė—L—pŦ‚ā•ņ‚ģ‚ę‚Ä‚Ē‚é17jjB⑤ŒŒī‚ð—p‚Ē‚―ę‡Ct‚ĖAKI ‚ð•]‰ŋ‚ĩ‚Ä‚Ē‚é‚Æ‚Ē‚Ī‚æ‚čCR‚Š‚ņ–ō‚É‚æ‚é‘Sg‚Ė‰e‹ŋ‚ð•]‰ŋ‚ĩ‚Ä‚Ē‚é‰Â”\Ŧ‚Š”Û’č‚Å‚Ŧ‚ļC‚Ü‚―C‚ŧ‚ĖÛC”N—î‚âCKD ‚āŠÜ‚ß‚―Šų‰‚Ė‡•đĮ‚Č‚Į‚Š‚Į‚Ė‚æ‚Ī‚ɉe‹ŋ‚·‚é‚Đ•s–ū‚Å‚ ‚é‚ą‚Æ‚Č‚Į‚Š‚ ‚°‚į‚ę‚éB

ƒoƒCƒIƒ}[ƒJ[‚Í‚í‚ę‚í‚ę‚ĖR‚Š‚ņ–ō‚É‹Nˆö‚·‚éAKI ‚ɑ΂·‚闝‰ð‚ð[‚ß‚Ä‚­‚ę‚é‚ŠCf’f‚ÉŠņ—^‚·‚é‚Đ‚Į‚Ī‚Đ•s–ū‚Č“_‚Š‘―‚ĒBR‚Š‚ņ‰ŧŠw—Ö@‚Ļ‚æ‚Ņtę–åˆã‚́C‚Ē‚ƒoƒCƒIƒ}[ƒJ[‚Š•K—v‚ЁC‚Į‚ĖƒoƒCƒIƒ}[ƒJ[‚Š—L—p‚ЁCƒoƒCƒIƒ}[ƒJ[‚Ėƒf[ƒ^‚ð‚Į‚Ė‚æ‚Ī‚ɉðŽß‚ĩŽĀÛ‚ĖŽĄ—Âɔ―‰f‚ģ‚đ‚é‚ЁCŒÂX‚ĖŠģŽŌ‚É‚Ļ‚Ē‚Ä”ŧ’f‚·‚é•K—v‚Š‚ ‚éB

yŽQl•ķŒĢz

1j Bellomo R, et al.Gfor the Acute Dialysis Quality Initiative workgroup. Acute renal failure-definition, outcome measures, animal models, fluid therapy and information technology needsFthe Second International Consensus Conference of the Acute Dialysis Quality InitiativeiADQIjGroup. Crit Care. 2004G8GR204-12. PMIDF15312219

2j Mehta RL, et al.Gfor the Acute Kidney Injury Network. Acute Kidney Injury NetworkFreport of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007G11FR31. PMIDF17331245

3j ‘剀ŒbK‚Ų‚ЁD–ōÜŦtáŠQD“ú–{—Տ°D2002G60i‘Š§jF493-500D

4j Lahoti A, et al. Predictors and outcome of acute kidney injury in patients with acute myelogenous leukemia or high-risk myelodysplastic syndrome. Cancer. 2010G116F4063-8. PMIDF20564156

5j Soares M, et al. Prognosis of critically ill patients with cancer and acute renal dysfunction. J Clin Oncol. 2006G24F4003-10. PMIDF16921054

6j Perazella MA, et al. New drug toxicities in the onco-nephrology world. Kidney Int. 2015G87F909-17. PMIDF25671763

7j Perazella MA. Onco-nephrologyFrenal toxicities of chemotherapeutic agents. Clin J Am Soc Nephrol. 2012G7F1713-21. PMIDF22879440

8j Arany I, et al. Cisplatin nephrotoxicity. Semin Nephrol. 2003G23F460-4. PMIDF13680535

9j Charlton JR, et al. A basic science view of acute kidney injury biomarkers. Nephrol Dial Transplant. 2014G29F1301-11. PMIDF24385545

10j Coca SG, et al. Biomarkers for the diagnosis and risk stratification of acute kidney injuryFa systematic review. Kidney Int. 2008G73F1008-16. PMIDF18094679

11j Ostermann M, et al. Clinical reviewFBiomarkers of acute kidney injuryFwhere are we now? Crit Care. 2012G16F233. PMIDF23014769

12j Katz R. Biomarkers and surrogate markersFan FDA perspective. NeuroRx. 2004G1F189-95. PMIDF15717019

13j Dieterle F, et al. Renal biomarker qualification submissionFa dialog between the FDA-EMEA and Predictive Safety Testing Consortium. Nat Biotechnol. 2010G28F455-62. PMIDF20458315

14j Kern W, et al. Microalbuminuria during cisplatin therapyFrelation with pharmacokinetics and implications for nephroprotection. Anticancer Res. 2000G20F3679-88. PMIDF11268439

15j Bonventre JV, et al. Next-generation biomarkers for detecting kidney toxicity. Nat Biotechnol. 2010G28F436-40. PMIDF20458311

16j Dieterle F, et al. Urinary clusterin, cystatin C, beta2-microgloburin and total protein as markers to detect drug-induced kidney injury. Nat Biotechnol. 2010G28F463-9. PMIDF20458316

17j Vaidya VS, et al. Urinary biomarkers for sensitive and specific detection of acute kidney injury in humans. Clin Transl Sci. 2008G1F200-8. PMIDF19212447

18j Kaseda R, et al. Megalin-mediated endocytosis of cystatin C in proximal tubule cells. Biochem Biophys Res Commun. 2007G357F1130-4. PMIDF17462596

19j Hojs R, et al. Serum cystatin C as an endogenous marker of renal function in patients with mild to moderate impairment of kidney function. Nephrol Dial Transplant. 2006G21F1855-62. PMIDF16524933

20j Vanmassenhove J, et al. Urinary and serum biomarkers for the diagnosis of acute kidney injuryFan in-depth review of the literature. Nephrol Dial Transplant. 2013G28F254-73. PMIDF23115326

21j Séronie-Vivien S, et al.GSFBC gBiology of renal function and renal failureh working group. Cystatin CFcurrent position and future prospects. Clin Chem Lab Med. 2008G46F1664-86. PMIDF18973461

22j Horio M, et al. Performance of serum cystatin C versus serum creatinine as a marker of glomerular filtration rate as measured by inulin renal clearance. Clin Exp Nephrol. 2011G15F868-76. PMIDF21861242

23j Benöhr P, et al. Cystatin C--a marker for assessment of the glomerular filtration rate in patients with cisplatin chemotherapy. Kidney Blood Press Res. 2006G29F32-5. PMIDF16582575

24j Tolkoff-Rubin NE, et al. Noninvasive renal diagnostic studies. Clin Lab Med. 1988G8F507-26. PMIDF2901937

25j Davey PG, et al. beta 2-Microglobulin instability in pathological urine. Clin Chem. 1982G28F1330-3. PMIDF6176371

26j Westhuyzen J, et al. Measurement of tubular enzymuria facilitates early detection of acute renal impairment in the intensive care unit. Nephrol Dial Transplant. 2003G18F543-51. PMIDF12584277

27j Goren MP, et al. Cumulative renal tubular damage associated with cisplatin nephrotoxicity. Cancer Chemother Pharmacol. 1986G18F69-73. PMIDF2875808

28j Ikeda H, et al. Urinary excretion of beta2-microglobulin and N-acetyl-beta-D-glucosaminidase in advanced neuroblastoma patients receiving cis-diamminedichloroplatinumiⅡj. Eur J Surg Oncol. 1988G14F17-20. PMIDF3278937

29j Bondiou MT, et al. Inhibition of A and B N-acetyl-beta-D-glucosaminidase urinary isoenzymes by urea. Clin Chim Acta. 1985G149F67-73. PMIDF4028434

30j Iqbal MP, et al. Urinary N-acetyl-beta-D-glucosaminidase in rheumatoid arthritis. Exp Mol Med. 1998G30F165-9. PMIDF9873839

31j Fujita H, et al. Increased urinary excretion of N-acetylglucosaminidase in subjects with impaired glucose tolerance. Ren Fail. 2002G24F69-75. PMIDF11921700

32j Tominaga M, et al. Urinary N-acetyl-beta-D-glucosaminidase in the patients with hyperthyroidism. Horm Metab Res. 1989G21F438-40. PMIDF2793065

33j Alge JL, et al. Biomarkers of AKIFa review of mechanistic relevance and potential therapeutic implications. Clin J Am Soc Nephrol. 2015G10F147-55. PMIDF25092601

34j Noiri E, et al. Urinary fatty acid-binding protein 1Fan early predictive biomarker of kidney injury. Am J Physiol Renal Physiol. 2009G296FF669-79. PMIDF19019918

35j Parikh CR, et al.Ffor the TRIBE-AKI Consortium. Performance of kidney injury molecule-1 and liver fatty acid-binding protein and combined biomarkers of AKI after cardiac surgery. Clin J Am Soc Nephrol. 2013G8F1079-88. PMIDF23599408

36j Doi K, et al. Evaluation of new acute kidney injury biomarkers in a mixed intensive care unit. Crit Care Med. 2011G39F2464-9. PMIDF21705884

37j Ferguson MA, et al. Urinary liver-type fatty acid-binding protein predicts adverse outcomes in acute kidney injury. Kidney Int. 2010G77F708-14. PMIDF19940842

38j Han WK, et al. Kidney Injury Molecule-1iKIM-1jFa novel biomarker for human renal proximal tubule injury. Kidney Int. 2002G62F237-44. PMIDF12081583

39j Ichimura T, et al. Kidney injury molecule-1Fa tissue and urinary biomarker for nephrotoxicant-induced renal injury. Am J Physiol Renal Physiol. 2004G286FF552-63. PMIDF14600030

40j Huang Y, et al. The clinical utility of kidney injury molecule 1 in the prediction, diagnosis and prognosis of acute kidney injuryFa systematic review. Inflamm Allergy Drug Targets. 2011G10F260-71. PMIDF21539514

41j Tekce BK, et al. Does the kidney injury molecule-1 predict cisplatin-induced kidney injury in early stage? Ann Clin Biochem. 2015G52F88-94. PMIDF24670880

42j Pennemans V, et al. Effect of pH on the stability of kidney injury molecule 1iKIM-1jand on the accuracy of its measurement in human urine. Clin Chem Acta. 2010G411F2083-6. PMIDF20837000

43j Haase M, et al.Gfor the NGAL Meta-analysis Investigator Group. Accuracy of neutrophil gelatinase-associated lipocaliniNGALjin diagnosis and prognosis in acute kidney injuryFa systematic review and meta-analysis. Am J Kidney Dis. 2009G54F1012-24. PMIDF19850388

44j Peres LA, et al. Evaluation of the cisplatin nephrotoxicity using the urinary neutrophil gelatinase-associated lipocaliniNGALjin patients with head and neck cancer. J Bras Nefrol. 2014G36F280-8. PMIDF25317609

45j Gaspari F, et al. Predicting cisplatin-induced acute kidney injury by urinary neutrophil gelatinase-associated lipocalin excretionFa pilot prospective case-control study. Nephron Clin Pract. 2010G115F154-60. PMIDF20407275

46j Yu Y, et al. Urinary biomarkers trefoil factor 3 and albumin enable early detection of kidney tubular injury. Nat Biotechnol. 2010G28F470-7. PMIDF20458317

47j Takeda M, et al. Urinary endothelin-1-like immunoreactivity in young male patients with testicular cancer treated by cis-platinumFcomparison with other urinary parameters. Clin SciiLondj. 1994G86F703-7. PMIDF7520380

48j Shin YJ, et al. Age-related differences in kidney injury biomarkers induced by cisplatin. Environ Toxicol Pharmacol. 2014G37F1028-39. PMIDF24751685


‚Q
  ‚Š‚ņ–ō•Ļ—Ö@Žž‚Ėt‹@”\’ቚ—\–h

i1j‘˜_

CQ3

t‹@”\‚Ė’ቚ‚ĩ‚―ŠģŽŌ‚ɑ΂ĩ‚ēŐŦ‚ðŒyŒļ‚·‚é‚―‚߂ɍR‚Š‚ņ–ō“Š—^—ĘŒļ—ʂ͐„§‚ģ‚ę‚é‚ЁH

t‹@”\‚Ė’ቚ‚ĩ‚―ŠģŽŌ‚É‚Ļ‚Ē‚Ä–ō•Ļ—LŠQŽ–Û‚ĖƒŠƒXƒN‚Š‚‚Ü‚é–ōÜ‚ł́CŒļ—Ę“Š—^‚ðs‚Ī‚ą‚Ƃ𐄏§‚·‚éB‚―‚ū‚ĩCŽĄ–ü‚ð–Ú•W‚Æ‚·‚éę‡‚ɂ̓ŠƒXƒNEƒxƒlƒtƒBƒbƒg‚Ėƒoƒ‰ƒ“ƒX‚ðl—ķ‚ĩ‚čŏI“I‚É“Š—^—Ę‚ðŒˆ’č‚·‚é•K—v‚Š‚ ‚éB

„§ƒOƒŒ[ƒh
s‚Ī‚ą‚Æ‚ðŽã‚­„§‚·‚éi’ņˆÄ‚·‚éj
—v@–ņ

t‹@”\‚Ė’ቚ‚ĩ‚―ŠģŽŌ‚É‚Ļ‚Ē‚Ä–ō•Ļ—LŠQŽ–Û‚ĖƒŠƒXƒN‚Š‚‚Ü‚é–ōÜ‚ł́CŒļ—Ę“Š—^‚ðs‚Ī‚ą‚Ƃ𐄏§‚·‚éB‚―‚ū‚ĩCŽĄ–ü‚ð–Ú•W‚Æ‚·‚éę‡‚É‚Í—˜‰v/•s—˜‰v‚Ėƒoƒ‰ƒ“ƒX‚ðl—ķ‚ĩ‚čŏI“I‚É“Š—^—Ę‚ðŒˆ’č‚·‚é•K—v‚Š‚ ‚éB

”wŒiE–Ú“I

t‚Í‘―‚­‚ĖR‚Š‚ņ–ō‚Æ‚ŧ‚Ė‘ãŽÓ•Ļ‚Ė”rŸ•Œo˜H‚Å‚ ‚čCt‹@”\áŠQ‚Š‘ķÝ‚·‚é‚ƍR‚Š‚ņ–ō‚Ė”rŸ•‚â‘ãŽÓ‚Š’x‰„‚ĩ‚ēŐŦ‚Š‘‹­‚·‚éę‡‚Š‚ ‚čCŒļ—Ę“Š—^‚Šl—ķ‚ģ‚ę‚é1jB‚Ü‚―CŠĖ‘Ÿ‚Å‘ãŽÓ‚ģ‚ę‚éR‚Š‚ņ–ō‚Å‚ ‚Á‚Ä‚āCt‹@”\’ቚŠģŽŌ‚ÅŒļ—Ę‚ðl—ķ‚·‚éę‡‚Š‚ ‚éB‚―‚Æ‚Ķ‚΃CƒŠƒmƒeƒJƒ“‚Í“§ÍŠģŽŌ‚Ö‚Ė“Š—^Žž‚É‚ÍŒļ—Ę‚Š•K—v‚ƍl‚Ķ‚į‚ę‚Ä‚Ē‚é2-5jB‚Ü‚―ƒ\ƒ‰ƒtƒFƒjƒu‚ā‚Ļ‚ā‚ÉŠĖ‘Ÿ‚Å‘ãŽÓ‚ģ‚ę‚é‚ŠCŒļ—Ę“Š—^‚ðl—ķ‚·‚Ũ‚Ŧ‚Æ‚Ē‚ĪˆÓŒĐ‚Š‚ ‚é6jB–{e‚Å‚ÍŒļ—Ę“Š—^‚ÉŠÖ‚·‚éƒGƒrƒfƒ“ƒX‚𑍊‡‚ĩCŽå—v‚ȍR‚Š‚ņ–ō‚ɂ‚Ē‚ÄŒļ—ĘŽwj‚ð’ņŽĶ‚·‚éB

‰ð@ā

‚ą‚ĖCQ3 ‚É“š‚Ķ‚é‚ɂ́Ct‹@”\’ቚŠģŽŌ‚É‚Ļ‚Ē‚Ä’Ęí—Ę“Š—^Žž‚ÆŒļ—Ę“Š—^Žž‚Ė–ō•Ļ—LŠQŽ–Û•p“x‚ð”äŠr‚ĩ‚―ŒĪ‹†‚Š•K—v‚Å‚ ‚é‚ŠCĄ‰ņ—p‚Ē‚―ŒŸõŽŪ‚Å‚ÍŠY“–‚·‚é˜_•ķ‚Í’Šo‚ģ‚ę‚Č‚Đ‚Á‚―B‚ą‚Ė‚æ‚Ī‚ČŒĪ‹†‚Í—Ï—“I‚É–â‘č‚Š‚ ‚čCŽĀŽ{‚Š“ï‚ĩ‚Ē‚ā‚Ė‚Ɛ„‘Š‚ģ‚ę‚éB“üŽč‰Â”\‚ČƒGƒrƒfƒ“ƒX7-10j‚Ė‘―‚­‚͐t‹@”\ģíŠģŽŌ‚Ɛt‹@”\’ቚŠģŽŌiŒļ—Ę“Š—^j‚É‚Ļ‚Ŋ‚é–ōÜ—LŠQŽ–Û‚Ė•p“x‚ð”äŠr‚ĩ‚―ŒĪ‹†‚ū‚ŠC‚ą‚Ė‚æ‚Ī‚ČŒĪ‹†‚ā”ņí‚ɏ­‚Č‚­CƒGƒrƒfƒ“ƒX‚ĖŽŋ‚Í”ņí‚É’á‚Ē‚Æ”ŧ’f‚ģ‚ę‚éiDFŒø‰Ę‚Ė„’č’l‚Š‚Ų‚Æ‚ņ‚ĮŠmM‚Å‚Ŧ‚Č‚ĒjB

„§“x‚ĖŒˆ’č‚É‚ ‚―‚Á‚Ä‚Í—˜‰v‚Æ•s—˜‰v‚Ėƒoƒ‰ƒ“ƒX‚Ėl—ķ‚Š‚Æ‚­‚ɏd—v‚Æ‚Č‚é‚ŠCŒļ—Ę‚ģ‚ę‚―ę‡‚ĖŽĄ—ÂƂĩ‚Ä‚Ė—LŒøŦ‚ÉŠÖ‚·‚éƒGƒrƒfƒ“ƒX‚ā–ō•Ļ—LŠQŽ–Û‚Æ“Ŋ—l‚É•s‘Ŧ‚ĩ‚Ä‚Ļ‚čCŽã‚Ē„§‚Æ‚Č‚Á‚―B

‚ĩ‚Đ‚ĩŽĀ—Տ°‚É‚Ļ‚Ē‚ẮCt‹@”\‚ɍ‡‚í‚đ‚Ä“Š—^—Ę‚ðŒļ—Ę‚ĩ–ō•ĻŒŒ’†”Z“x‚ðƒRƒ“ƒgƒ[ƒ‹‚ĩ‚æ‚Ī‚Æ‚·‚鎎‚Ý‚Šs‚í‚ę‚Ä‚Ļ‚čC­”‚Å‚ ‚é‚ŠŽQl‚Æ‚Č‚éŒĪ‹†‚âƒKƒCƒhƒ‰ƒCƒ“‚Š‘ķÝ‚·‚éB‚―‚Æ‚Ķ‚΃Jƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚É‚Ļ‚Ē‚Ä‚Í‘æ‡T‘ŠŽŽŒą‚ĖŒ‹‰Ę‚ÉŠî‚ÂĒ‚Ätarget AUC ‚ÆCockcroft-Gault ŽŪ‚É‚æ‚鐄’čCcr ‚Đ‚į“Š—^—Ę‚ðŒvŽZ‚·‚éCalvert ŽŪ‚Š‘ķÝ‚·‚éiÚŨ‚ɂ‚Ē‚Ä‚ÍCQ10 ‚ðŽQÆj11jB‚Ü‚―C“ú–{l‚Å‚Ėƒf[ƒ^‚ð‚ā‚Æ‚É‚ĩ‚―CģCalvert ŽŪ‚ā•ņ‚ģ‚ę‚Ä‚Ē‚é12jB

“ú–{‚É‚Ļ‚Ē‚ÄŒļ—Ę“Š—^•û–@‚ð–Ô—…‚ĩ‚―ƒKƒCƒhƒ‰ƒCƒ“‚Í‘ķÝ‚ĩ‚Č‚Ē‚ŠC“ú–{t‘Ÿ•a–ō•Ļ—Ö@Šw‰ï13j‚Š‘―‚­‚ĖR‚Š‚ņ–ō‚ĖŒļ—Ę•û–@‚ɂ‚Ē‚ÄŒĐ‰ð‚ðŽĶ‚ĩ‚Ä‚Ē‚é‚Ų‚Ёi•\jCŠeŽíŽ‘‚ɍR‚Š‚ņ–ō‚ĖŒļ—Ę‚ÉŠÖ‚·‚é‹LÚ‚Š‘ķÝ‚·‚é14jBŠCŠO‚É‚Ļ‚Ē‚Ä‚ÍFDA15j‚â‰ĒBˆã–ō•i’ĄiEMAj16j‚ŠŠe–ōÜ‚Ė“Y•t•ķ‘‚É‚Ļ‚Ē‚Đt‹@”\’ቚŠģŽŌ‚Å‚Ė“Š—^•û–@‚ɂ‚Ē‚Ä‹LÚ‚·‚é‚æ‚ĪŽwj‚ðo‚ĩ‚Ä‚Ļ‚čC‚ą‚ę‚į‚Ė‹@ŠÖ‚ŠŒöŠJ‚ĩ‚Ä‚Ē‚é“Y•t•ķ‘‚ŠŽQl‚É‚Č‚é‰Â”\Ŧ‚Š‚ ‚éB

‚Č‚ĻCR‚Š‚ņ–ō‚Å‚Í—LŒøˆæ‚ƓŐŦˆæ‚Š‚Ŧ‚í‚߂ċߐڂĩ‚Ä‚Ļ‚čCŽĄ—Öō•Ļƒ‚ƒjƒ^ƒŠƒ“ƒOiTDMj‚Š—L—p‚ƍl‚Ķ‚į‚ęCŽĀÛ‚Éˆę•”‚ĖR‚Š‚ņ–ō‚ł̓‰ƒ“ƒ_ƒ€‰ŧ”äŠrŽŽŒą‚ÅTDM ‚Ė—LŒøŦ‚ŠØ–ū‚ģ‚ę‚Ä‚Ē‚é17, 18jB‚ĩ‚Đ‚ĩCŒŧÝ‚Ė‚Æ‚ą‚ëR‚Š‚ņ–ō‚ĖŒŒ’†”Z“x‘Š’č‚ðs‚ĪŽŽ‚݂͈ę”Ę“I‚Å‚Í‚Č‚ĒB

ŒŧŽĀ“I‚ȑΉž‚Æ‚ĩ‚āCt‹@”\’ቚŠģŽŌ‚Å‚Í‘Oq‚Ė—p—Ę’ēßŽwj‚ðŽQl‚É“Š—^‚ðŠJŽn‚ĩC’ʏí‚æ‚č‚ā—LŠQŽ–Û‚Ėƒ‚ƒjƒ^ƒŠƒ“ƒO‚𖧂ɍs‚Á‚āCˆČŒã‚ĖŽĄ—ÂɂĻ‚Ŋ‚é—p—Ę‚Ė‘Œļ‚ðŒŸ“Ē‚·‚é‚ą‚Æ‚Š–]‚Ü‚ĩ‚Ē‚ÆŽv‚í‚ę‚éB‚Ü‚―CŽĄ–ü‚ð–Ú•W‚Æ‚·‚éĮ—á‚É‚Ļ‚Ē‚Ä‚Í—˜‰v/•s—˜‰v‚Ėƒoƒ‰ƒ“ƒX‚ðl—ķ‚ĩ‚čŏI“I‚É“Š—^—Ę‚ðŒˆ’č‚·‚é•K—v‚Š‚ ‚éB

•\@‚Ļ‚ā‚ȍR‚Š‚ņ–ō‚É‚Ļ‚Ŋ‚ét‹@”\’ቚŽž‚ĖŒļ—Ę•û–@
ˆę”Ę–ž

í—p—Ę

GFR ‚Ü‚―‚ÍCcrimL/•Šj

ŒŒ‰t“§ÍiHDjC
• –Œ“§ÍiPDj

„80

70

60

50

40

30

20

10„

’†“™“xtáŠQ

d“xtáŠQ

––Šút•s‘S

ƒVƒXƒvƒ‰ƒ`ƒ“1, 13j “Y•t•ķ‘ŽQÆ Ccr 31`45 mL/•ŠF
50“‚ÉŒļ—ʁC
Ccr 46`60 mL/•ŠF
75“‚ÉŒļ—Ę
‹ÖŠõ‚ū‚Š•K—v‚Čę‡‚Í
50“‚ÉŒļ—Ę‚ĩ‚Ä“Š—^
‹ÖŠõ‚ū‚ŠC•K—v‚Čę‡‚É‚ÍHD ŠģŽŌ‚Í“§ÍŒã‚É50“ ‚ðCAPD ŠģŽŌ‚Í50“‚ÉŒļ—Ę‚ĩ‚Ä“Š—^
ƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“13j 1 ‰ņ300`400 mg/m2“Š—^‚ĩC­‚Č‚­‚Æ‚ā4 TŠÔ‹x–ō‚·‚éB‚ą‚ę‚ð1 ƒN[ƒ‹‚Æ‚·‚éB Calvert ‚ĖŽŪFAUC –Ú•W’l~iGFR{25jimgj‚É‚æ‚Á‚ÄŽZo‚ĩC’P“Æ“Š—^‚Ėę‡C‰‰ņ‚ÍAUC 7 mg/mLE•Š‚ðCŒJ‚č•Ô‚ĩ“Š—^‚Ė‚Æ‚Ŧ‚ÍAUC 4`5 mg/mLE•Š‚ð–Ú•W‚É“Š—^‚·‚éB“§ÍŠģŽŌ‚ĖGFR ‚Í5`10 ‚ð‘ã“ü‚·‚éB‚―‚ū‚ĩ–{–@‚ĖŒŒīCr ’l‚ÍJaffé –@‚ð—p‚Ē‚Ä‚Ē‚é‚―‚߁CCG ŽŪ‚ð—p‚Ē‚é‚ÆCcr ‚æ‚č‚āGFR ‚ɋߎ—‚·‚éBŽ_‘f–@‚Å‘Š’č‚ģ‚ę‚é“ú–{‚Å‚ÍCG ŽŪ‚ð—p‚Ē‚é‚ÆCcr ‚Š‚‚߂ɐ„ŽZ‚ģ‚ę‚é‚―‚߉ߗʓŠ—^‚É‚Č‚č‚â‚·‚­CŒŒīCr ’l‚É0.2 ‚ð‰Á‚Ķ‚é•û–@19j‚â‘Ė•\–ĘÏ•âģ‚ðŠO‚ĩ‚―eGFR ‚ð—p‚Ē‚é‚ą‚Æ‚Š„§‚ģ‚ę‚éB
ƒƒgƒgƒŒƒLƒT[ƒg13, 20j “Y•t•ķ‘ŽQÆ 50“‚ÉŒļ—Ę ”rŸ•’x‰„‚É‚æ‚č•›ė—p‚Š‹­‚­‚ ‚į‚í‚ę‚é‚Ļ‚ŧ‚ę‚Š‚ ‚é‚―‚ß‹ÖŠõ
ƒJƒyƒVƒ^ƒrƒ“21j “Y•t•ķ‘ŽQÆ Ccr 30`50 mL/•Š‚Å‚Í75“ ‚ÉŒļ—Ę ‹ÖŠõ
ƒeƒKƒt[ƒ‹EƒMƒƒ‰ƒVƒ‹E
ƒIƒeƒ‰ƒVƒ‹ƒJƒŠƒEƒ€13, 22j
Ccr†80 mL/•Š‚Å‚Í’ĘíC‘Ė•\–ĘÏ‚É‡‚í‚đ‚Ä1‰ņ40C50C60 mg ‚ð‰‰ņŠî€—Ę‚Æ‚ĩC1 “ú2 ‰ņ28 “úŠÔ˜A“úŒoŒû“Š—^‚ĩC‚ŧ‚ĖŒã14 “úŠÔ‹x–ō‚·‚éB‚ą‚ę‚ð1 ƒN[ƒ‹‚Æ‚ĩ‚Ä“Š—^‚ðŒJ‚č•Ô‚·B80„Ccr†60 mL/•Š‚ł͏‰‰ņŠî€—Ę‚æ‚č•K—v‚ɉž‚ķ‚Ä1 ’iŠKŒļ—ʁC60„Ccr†40 mL/•Š‚Å‚ÍŒī‘Ĩ‚Æ‚ĩ‚Ä1 ’iŠKŒļ—ʁC40„Ccr†30 mL/•Š‚Å‚ÍŒī‘Ĩ‚Æ‚ĩ‚Ä2 ’iŠKŒļ—Ę‚·‚éBCcrƒ30 mL/•Š‚Í“Š—^•s‰ÂB
Œļ—Ę•û–@F40 mg/‰ņĻ ‹x–ōC50 mg/‰ņĻ40 mg/‰ņĻ‹x–ōC60 mg/‰ņĻ50 mg/‰ņĻ40 mg/‰ņĻ‹x–ō‚Ü‚―‚͐t‹@”\‚ɉž‚ķ‚Ä“K‹XŒļ—Ę‚ðl—ķB
d“ĂȐt‹@”\áŠQ‚Ė‚ ‚éŠģŽŌ‚ł́C5-FU ‚ĖˆŲ‰ŧ‘ãŽÓy‘f‘jŠQ–ōƒMƒƒ‰ƒVƒ‹‚Ėt”rŸ•‚Š’˜‚ĩ‚­’ቚ‚ĩCŒŒ’†5-FU ‚Ė”Z“x‚Šãļ‚ĩCœ‘—}§‚Č‚Į‚Ė•›ė—p‚Š‹­‚­Œŧ‚ę‚é‚Ļ‚ŧ‚ę‚Š‚ ‚é‚―‚ß‹ÖŠõB
ƒCƒzƒXƒtƒ@ƒ~ƒh23j “Y•t•ķ‘ŽQÆ Ccr 46`60 mL/•Š‚Å‚Í80“‚ÉŒļ—Ę   Ccr 31`45 m L/•Š‚Å‚Í75“‚ÉŒļ—Ę Ccr 30 mL/•ŠˆČ‰š‚Å‚Í70“‚ÉŒļ—Ę “§ÍŦ‚Š‚ ‚ŠC’Į‰Á“Š—^‚Ė•K—v‚Č‚ĩB

CAPDF˜A‘ąŒgsŽŪ• –Œ“§ÍCCGFCockcroft-Gault

“ú–{t‘Ÿ•a–ō•Ļ—Ö@Šw‰ï. t‹@”\’ቚŽž‚ɍłā’ˆÓ‚Ė•K—v‚Č–ōÜ“Š—^—Ęˆę——
i2015 ‰ü’ų26 ”Łj//jsnp.org/ckd/yakuzaitoyoryo.php ‚æ‚č”ēˆ.

yŽQl•ķŒĢz

1j Merchan JR. Chemotherapy-related nephrotoxicity and dose modification in patients with renal insufficiency. InFUpToDate, Post TWiEdj, UpToDate, 2016.

2j Fujita K, et al. Increased Plasma Concentrations of Unbound SN-38, the Active Metabolite of Irinotecan, in Cancer Patients with Severe Renal Failure. Pharm Res. 2016G33F269-82. PMIDF26337772

3j Fujita K, et al. Delayed elimination of SN-38 in cancer patients with severe renal failure. Drug Metab Dispos. 2011G39F161-4. PMIDF20980446

4j —`Î°–į‚Ų‚ЁDŒŒ‰t“§Í’†”xŽŨ–EŠā‚ɑ΂·‚éCarboplatin{CPT-11 ‰ŧŠw—Ö@‚ĖŒoŒąDŠā‚ƉŧŠw—Ö@D2007G34F2071-3.

5j ŽÂč‰pŽi‚Ų‚ЁDŒŒ‰t“§Í—Ö@‚ðŽ{s‚ĩ‚Ä‚Ē‚é’ž’°ŠāÄ”­ŠģŽŌ‚ɑ΂·‚éCPT-11 “ą“ü‚ĖŒoŒąDŠā‚ƉŧŠw—Ö@D2005G32F397-9.

6j Kennoki T, et al. Clinical results and pharmacokinetics of sorafenib in chronic hemodialysis patients with metastatic renal cell carcinoma in a single center. Jpn J Clin Oncol. 2011G41F647-55.PMIDF21367805

7j Calvert AH, et al. Phase‡T studies with carboplatin at the Royal Marsden Hospital. Cancer Treat Rev. 1985G12 Suppl AF51-7. PMIDF3910222

8j Moon HH, et al. Prediction of nephrotoxicity induced by cisplatin combination chemotherapy in gastric cancer patients. World J Gastroenterol. 2011G17F3510-7. PMIDF21941418

9j Maru S, et al. Influence of baseline renal function and dose reduction of nephrotoxic chemotherapeutic agents on the outcome of metastatic urothelial carcinomaFa retrospective study. Int J Urol. 2012G19F110-6. PMIDF22126100

10j Šâˆä”ü“Þ‚Ų‚ЁDt‹@”\‚ÉŠî‚ÂĒ‚―ƒJƒyƒVƒ^ƒrƒ“‚Ė•›ė—p•]‰ŋDŠā‚ƉŧŠw—Ö@D2012G39F783-92.

11j Calvert AH, et al. Carboplatin dosageFprospective evaluation of a simple formula based on renal function. J Clin Oncol. 1989G7F1748-56. PMIDF2681557

12j Shimokata T, et al. Prospective evaluation of pharmacokinetically guided dosing of carboplatin in Japanese patients with cancer. Cancer Sci. 2010G101F2601-5. PMIDF20860621

13j “ú–{t‘Ÿ•a–ō•Ļ—Ö@Šw‰ï@

14j American Pharmacists Association. Drug Information HandbookFA Clinically Relevant Resource for All Healthcare Professionals. Lexi Comp, 2014.

15j U.@S. Department of Health and Human Services Food and Drug Administration Center for Drug Evaluation and ResearchiCDERj. Guidance for industry pharmacokinetics in patients with impaired renal function\study design, data analysis, and impact on dosing and labeling. Draft guidance. 2010.

16j European Medicines Agency. Draft guideline on the evaluation of the pharmacokinetics of medicinal products in patients with decreased renal function.

17j Fety R, et al. Clinical impact of pharmacokinetically-guided dose adaptation of 5-fluorouracilFresults from a multicentric randomized trial in patients with locally advanced head and neck carcinomas. Clin Cancer Res. 1998G4F2039-45. PMIDF9748117

18j Gamelin E, et al. Individual fluorouracil dose adjustment based on pharmacokinetic follow-up compared with conventional dosageFresults of a multicenter randomized trial of patients with metastatic colorectal cancer. J Clin Oncol. 2008G26F2099-105. PMIDF18445839

19j Ando M, et al. Multi-institutional validation study of carboplatin dosing formula using adjusted serum creatinine level. Clin Cancer Res. 2000G6F4733-8. PMIDF11156227

20j Aronoff GM, et al. Drug Prescribing in Renal FailureFDosing Guidelines for Adults and Children. 5th, American College of Physicians, 2007.

21j Superfin D, et al. CommentaryFOncologic drugs in patients with organ dysfunctionFa summary. Oncologist. 2007G12F1070-83. PMIDF17914077

22j Shiroyama T, et al. Phase Ⅱ tailored S-1 regimen study of first-line chemotherapy in elderly patients with advanced and recurrent non-small cell lung cancer. Cancer Chemother Pharmacol. 2012G70F783-9. PMIDF22960985

23j Kintzel PE, et al. Anticancer drug renal toxicity and eliminationFdosing guidelines for altered renal function. Cancer Treat Rev. 1995G21F33-64. PMIDF7859226


i2j”’‹āŧÜ

CQ4

ƒVƒXƒvƒ‰ƒ`ƒ“‚É‚æ‚éAKI ‚ð—\‘Š‚·‚é‚―‚߂ɁCƒŠƒXƒNˆöŽq‚É‚æ‚é•]‰ŋ‚͐„§‚ģ‚ę‚é‚ЁH

ƒVƒXƒvƒ‰ƒ`ƒ“‚É‚æ‚éAKI ‚ð—\‘Š‚·‚éˆöŽq‚Æ‚ĩ‚āC’áƒAƒ‹ƒuƒ~ƒ“ŒŒĮC‹i‰ŒC—ŦC‚—îi1 Î‚ ‚―‚č1.03 ”{ƒŠƒXƒN‚Š‘‚Ķ‚éjC‘ž‚ĖR‚Š‚ņ–ō‚Ė•đ—pCŒŒīƒJƒŠƒEƒ€CSEŒŒŠĮŒnŽūŠģ‚â“œ”A•a‚Ė‡•đCis‚Š‚ņCƒVƒXƒvƒ‰ƒ`ƒ“‘“Š—^—Ę‚Č‚Į‚Š•ņ‚ģ‚ę‚Ä‚Ē‚éBƒVƒXƒvƒ‰ƒ`ƒ“‚É‚æ‚éAKI ‚ð–h‚Ū‚―‚߂ɁC“Š—^‘O‚ɃŠƒXƒNˆöŽq‚ð•]‰ŋ‚·‚é‚ą‚Ƃ𐄏§‚·‚éB

„§ƒOƒŒ[ƒh
s‚Ī‚ą‚Æ‚ðŽã‚­„§‚·‚éi’ņˆÄ‚·‚éj
—v@–ņ

ƒVƒXƒvƒ‰ƒ`ƒ“‚É‚æ‚éAKI ‚ð—\‘Š‚·‚éˆöŽq‚Æ‚ĩ‚āC’áƒAƒ‹ƒuƒ~ƒ“ŒŒĮC‹i‰ŒC—ŦC‚—îi1 Î‚ ‚―‚č1.03 ”{ƒŠƒXƒN‚Š‘‚Ķ‚éjC‘ž‚ĖR‚Š‚ņ–ō‚Ė•đ—pCŒŒīƒJƒŠƒEƒ€CSEŒŒŠĮŒnŽūŠģ‚â“œ”A•a‚Ė‡•đCis‚Š‚ņCƒVƒXƒvƒ‰ƒ`ƒ“‘“Š—^—Ę‚Č‚Į‚Š•ņ‚ģ‚ę‚Ä‚Ē‚éB‚ĩ‚Đ‚ĩC‚ŧ‚ę‚ž‚ę‚Ė•ņ‚ÅAKI ‚Ė’č‹`‚Šˆę’č‚ĩ‚Ä‚Ļ‚į‚ļC‚ģ‚į‚ɃŠƒXƒNˆöŽq‚Ė臒l‚Š–ū‚į‚Đ‚Å‚Í‚Č‚­CƒŠƒXƒNˆöŽq‚ð—L‚·‚éę‡‚Ė‘Ήž‚ɂ‚Ē‚Ä‚āŠm—§‚ĩ‚Ä‚Ē‚Č‚Ē‚Č‚ĮCĄŒã‚ĖŒŸ“Ē‰Û‘č‚ÍŽc‚é

”wŒiE–Ú“I

ƒVƒXƒvƒ‰ƒ`ƒ“‚Í‘―‚­‚Ė‚Š‚ņŽí‚ɑ΂·‚éR‚Š‚ņ–ōŽĄ—ÂĖkey drug ‚Å‚ ‚čC‚ā‚Á‚Æ‚ā”Ä—p‚ģ‚ę‚Ä‚Ē‚éR‚Š‚ņ–ō‚Ėˆę‚‚ł ‚éB‚ĩ‚Đ‚ĩCƒVƒXƒvƒ‰ƒ`ƒ“‚ɂ͍œ‘—}§‚âÁ‰ŧŠĮ“ŐŦC_Œo“ŐŦ‚Č‚Į‚Š’m‚į‚ęC‚Č‚Đ‚Å‚āt“ŐŦ‚Í‚ŧ‚ĖŒã‚ĖƒVƒXƒvƒ‰ƒ`ƒ““Š—^‹K’čˆöŽq‚Æ‚ā‚Č‚č‚Ī‚éd—v‚Č•›ė—p‚Å‚ ‚éBƒVƒXƒvƒ‰ƒ`ƒ““Š—^Į—á‚Ė1/3 ‚ÍAKI ‚ð‡•đ‚·‚é‚Æ‘z’č‚ģ‚ę1jCAKI ‚É‚æ‚č‚ŧ‚ĖŒã‚ĖƒVƒXƒvƒ‰ƒ`ƒ““Š—^‚Š§ŒĀ‚ģ‚ę‚é‚ą‚Æ‚ā­‚Č‚­‚Č‚ĒB‚ģ‚į‚ÉAKI ‚Đ‚į–Ŧ”AŨŠĮŠÔŽŋüˆÛ‰ŧĮ‚â•s‰Â‹t“I‚Č–Ŧ”AŨŠĮĮ‚Æ‚Č‚čCKD ‚ɐis‚·‚é‚ą‚Æ‚ā‚ ‚é2, 3jB–{e‚ł̓VƒXƒvƒ‰ƒ`ƒ“‚É‚æ‚éAKI ”­Į‚ð—\‘Š‚·‚郊ƒXƒNˆöŽq‚ðŒŸ‚ĩ‚―B

‰ð@ā

ƒVƒXƒvƒ‰ƒ`ƒ“‚É‚æ‚étáŠQ‚Í‚Ļ‚ā‚É‹ßˆĘ”AŨŠĮC‚Æ‚­‚ÉS3 ƒZƒOƒƒ“ƒg‚ĖáŠQ‚É‚æ‚é‚Æ‚ģ‚ę‚Ä‚Ē‚é4jBƒVƒXƒvƒ‰ƒ`ƒ“‚ŠŠî’ę–Œ‘Ī‚Đ‚įŨ–E“ā‚ÉŽæ‚荾‚Ü‚ęCƒ~ƒgƒRƒ“ƒhƒŠƒADNA ‚ðáŠQ‚ĩ‚ăAƒ|ƒg[ƒVƒX‚ŠŠˆŦ‰ŧ‚·‚éB‚ģ‚į‚ɃVƒXƒvƒ‰ƒ`ƒ“‚ĖŨ–E“ā’ū’…‚É‚æ‚čC‰ŠĮ‚âŽ_‰ŧƒXƒgƒŒƒXC‹•ŒŒŦáŠQ‚ā”­ķ‚·‚é2jB‚Ü‚―C’áƒ}ƒOƒlƒVƒEƒ€ŒŒĮ‚ātáŠQ‚ĖŒīˆö‚Ėˆę‚‚ƍl‚Ķ‚į‚ę‚Ä‚Ē‚éBƒ}ƒOƒlƒVƒEƒ€‚͐t”AŨŠĮ‚É‚Ļ‚Ŋ‚é”\“Ū—A‘—‹@\‚ÉŠÖ—^‚·‚é‚Æ‚ģ‚ęCSobrero ‚į‚Í’áƒ}ƒOƒlƒVƒEƒ€ŒŒĮ‚É‚æ‚čt”AŨŠĮŨ–E‚É‚Ļ‚Ŋ‚éƒVƒXƒvƒ‰ƒ`ƒ“”Z“x‚Šãļ‚ĩC‹ßˆĘ”AŨŠĮáŠQ‚Š‹N‚ą‚é‚Æ‘z’č‚ĩ‚Ä‚Ē‚é5jB

de Jongh ‚į6j‚́C‹ĮŠisŦ‚ ‚é‚Ē‚Í“]ˆÚŦˆŦŦŽîá‡400 —á‚ɑ΂·‚éƒVƒXƒvƒ‰ƒ`ƒ“–ˆT“Š—^Į—á‚ðŒŸ“Ē‚ĩ‚―B400 —á’†36“‚̓VƒXƒvƒ‰ƒ`ƒ“’PÜC49“‚̓Gƒgƒ|ƒVƒhC15“‚̓pƒNƒŠƒ^ƒLƒZƒ‹‚ð•đ—p‚ĩ‚Ä‚Ē‚éBCcr 25“ˆČã‚Ė’ቚ‚Í116 —ái29“j‚É‚Ý‚į‚ęCtáŠQ‚É‚æ‚éƒVƒXƒvƒ‰ƒ`ƒ““Š—^Œp‘ą•s‰ÂĮ—á‚Í29 —ái7“j‚Å‚ ‚Á‚―BƒVƒXƒvƒ‰ƒ`ƒ““Š—^Œãt‹@”\’ቚ‚Ė“Æ—§‚ĩ‚―—\‘ŠˆöŽq‚́C‘―•Ï—ʉðÍ‚ł́CƒpƒNƒŠƒ^ƒLƒZƒ‹•đ—piƒIƒbƒY”ä4.0Cp0.001jC’áƒAƒ‹ƒuƒ~ƒ“ŒŒĮiƒIƒbƒY”ä3.5Cp0.006jC‹i‰ŒiƒIƒbƒY”ä2.5Cp0.002jC—ŦC‚—î‚Å‚ ‚Á‚―B”N—î•Ę‚Å‚Í48 Î–Ē–ž26“C48`62 Î35“C62 Î’ī41“‚ƉÁ—î‚Æ‚Æ‚ā‚ɐtáŠQ‚ĖƒŠƒXƒN‚Š‘‚ĶC1 Î‚ ‚―‚č1.03 ”{ƒŠƒXƒN‚Š‘‰Á‚ĩ‚―i ƒIƒbƒY”ä1.03Cp0.007jBŦ•Ę‚ł͏—Ŧ‚Ė‚Ų‚Ī‚Š’jŦ‚æ‚č2 ”{ƒŠƒXƒN‚Š‚‚Đ‚Á‚―iƒIƒbƒY”ä2.0Cp0.025jB—Ŧ‚Í’jŦ‚æ‚čƒVƒXƒvƒ‰ƒ`ƒ“”rŸ•”\‚Š’á‚Ē‚Æ‚Ē‚Ī•ņ‚ā‚ ‚é‚Š7jC‚ą‚ĖŒīˆö‚Í–ū‚į‚Đ‚Å‚Í‚Č‚ĒB‹i‰Œ‚ĖŠÖ—^‚ɂ‚Ē‚Ä‚ÍŽ_‰ŧƒXƒgƒŒƒX‚Ė‰e‹ŋ‚Č‚Į‚Š„‘Š‚ģ‚ę‚Ä‚Ē‚é‚Š8jC‹i‰Œ‚ŠSŒŒŠĮáŠQ‚ðˆø‚Ŧ‹N‚ą‚ĩC“ņŽŸ“I‚ɃVƒXƒvƒ‰ƒ`ƒ““Š—^Œã‚Ėt‹@”\‚ɂ‚ȂŠ‚Á‚―‰Â”\Ŧ‚ā”Û’č‚Å‚Ŧ‚Č‚ĒB‚Ü‚―C’áƒAƒ‹ƒuƒ~ƒ“ŒŒĮ‚Å‚Í”ņƒ^ƒ“ƒpƒNŒ‹‡Œ^ƒVƒXƒvƒ‰ƒ`ƒ“”Z“x‚Šãļ‚·‚é‚ą‚Æ‚É‚æ‚čt“ŐŦ‚Š‘‚·‚ƍl‚Ķ‚į‚ę‚Ä‚Ē‚é6jB‚Č‚ĻC–{•ņ‚ÍCcr 25“ˆČã‚Ė’ቚ‚ðtáŠQ‚Ė’č‹`‚Æ‚ĩ‚Ä‚Ļ‚čCŒĩ–§‚É‚ÍAKI ‚ð—\‘Š‚·‚éˆöŽq‚Æ‚ĩ‚Ä•]‰ŋ‚ĩ‚―•ņ‚Å‚Í‚Č‚ĒB

Stewart ‚į9j‚Í425 —áiƒVƒXƒvƒ‰ƒ`ƒ“‘“Š—^—Ę220mg/m2m’†‰›’lnj‚ĖŒŸ“Ē‚ð•ņ‚ĩ‚―BƒVƒXƒvƒ‰ƒ`ƒ““Š—^I—đŒã4 T‚Ü‚Å‚ĖŒŒīCr Å‘呝‰Á—Ę‚Ė—\‘ŠˆöŽq‚́C‘―•Ï—ʉðÍ‚Å‚ÍŒŒīƒAƒ‹ƒuƒ~ƒ“CŒŒīƒJƒŠƒEƒ€C‘Ė•\–ĘÏC“Š—^‰ņ”‚Å‚ ‚é‚Æ•ņ‚ĩ‚―B–{•ņ‚Ė–â‘č“_‚Æ‚ĩ‚āCt‹@”\‚Ė•]‰ŋ‚ðŒŒīCr ‚Ė‚݂ōs‚Á‚Ä‚Ē‚é‚ą‚Æ‚âCƒVƒXƒvƒ‰ƒ`ƒ““Š—^I—đŒã4 T‚Ü‚Å‚ĖŒŒīCr Å‘呝‰Á—Ę‚Å•]‰ŋ‚ĩ‚Ä‚Ē‚é‚ŠCŒˆ‚ĩ‚ÄŠm—§‚ĩ‚―•]‰ŋ•û–@EŽžŠú‚Å‚Í‚Č‚Ē‚ą‚Æ‚Š‚ ‚°‚į‚ę‚éB‚ģ‚į‚ɍR‚Š‚ņ–ō‚āŠÜ‚ß‚Ä‘ž‚Ė‘―‚­‚Ė–ō‚ð•đ—p‚ĩ‚Ä‚Ļ‚čCƒVƒXƒvƒ‰ƒ`ƒ“‚Š‚Į‚Ė’ö“xt‹@”\‚Ė•Ï‰ŧ‚ÉŠņ—^‚ĩ‚Ä‚Ē‚é‚Đ•s–ū‚Å‚ ‚éB

Mizuno ‚į10j‚Í1,721 —á‚ĖƒVƒXƒvƒ‰ƒ`ƒ““Š—^Į—á‚ðŒŸ“Ē‚ĩ‚―B‘―•Ï—ʉðÍ‚ł́C•aŠúf’fstage 4 ‚Ėis‚Š‚ņiƒIƒbƒY”ä1.8Cp0.011jCƒVƒXƒvƒ‰ƒ`ƒ“‘“Š—^—Ę‚Š’†“™“xAKIiƒVƒXƒvƒ‰ƒ`ƒ““Š—^7 “úˆČ“ā‚ĖŒŒīCr ‚Š1.5`1.9 ”{‘‰Áj‚ĖƒŠƒXƒNˆöŽq‚ŁCSŒŒŠĮŽūŠģ‚Ė‡•đC“œ”A•a‚Ė‡•đC•aŠúf’fstage 4 ‚Ėis‚Š‚ņ‚Šd“xAKIiƒVƒXƒvƒ‰ƒ`ƒ““Š—^7 “úˆČ“ā‚ĖŒŒīCr ‚Š2.0 ”{ˆČã‘‰Áj‚ĖƒŠƒXƒNˆöŽq‚Å‚ ‚Á‚―B

‚ą‚Ė‚æ‚Ī‚ɁCŒŧÝ‚Ü‚ÅAKI ‚ð—\‘Š‚·‚éˆöŽq‚Æ‚ĩ‚Ä‚Ē‚­‚‚ЂĖ•ņ‚Š‚ ‚éB‚ĩ‚Đ‚ĩC‚Ē‚ļ‚ę‚āAKI‚Ė’č‹`‚Šˆę’č‚ĩ‚Ä‚Ļ‚į‚ļCRIFLE •Š—Þ‚âAcute Kidney Injury NetworkiAKINj‚Ė•Š—Þ‚É‘Ĩ‚Á‚―•ņ‚Š‚Č‚ĒB‚ģ‚į‚ɃŠƒXƒNˆöŽq‚Ė臒l‚Š–ū‚į‚Đ‚Å‚Č‚­CƒŠƒXƒNˆöŽq‚ð—L‚·‚éę‡‚Ė‘Ήž‚ɂ‚Ē‚Ä‚āŠm—§‚ĩ‚Ä‚Ē‚Č‚ĒBĄŒã‚ĖŒŸ“Ē‰Û‘č‚ƍl‚Ķ‚éB

yŽQl•ķŒĢz

1j Arany I, et al. Cisplatin nephrotoxicity. Semin Nephrol. 2003G23F460-4. PMIDF13680535

2j Pabla N, et al. Cisplatin nephrotoxicityFmechanisms and renoprotective strategies. Kidney Int. 2008G73F994-1007. PMIDF18272962

3j Perazella MA, et al. Nephrotoxicity from chemotherapeutic agentsFclinical manifestations, pathobiology, and prevention/therapy. Semin Nephrol. 2010G30F570-81. PMIDF21146122

4j Dobyan DC, et al. Mechanism of cis-platinum nephrotoxicityFⅡ. Morphologic observations. J Pharmacol Exp Ther. 1980G213F551-6. PMIDF7193726

5j Sobrero A, et al. Current strategies to reduce cisplatin toxicity. J Chemother. 1990G2F3-7. PMIDF2185345

6j de Jongh FE, et al. Weekly high-dose cisplatin is a feasible treatment optionFanalysis on prognostic factors for toxicity in 400 patients. Br J Cancer. 2003G88F1199-206. PMIDF12698184

7j de Jongh FE, et al. Body-surface area-based dosing does not increase accuracy of predicting cisplatin exposure. J Clin Oncol. 2001G19F3733-9. PMIDF11533095

8j Maytin M, et al. Oxidant stress in the vasculature. Curr Atheroscler Rep. 1999G1F156-64. PMIDF11122705

9j Stewart DJ, et al. Association of cisplatin nephrotoxicity with patient characteristics and cisplatin administration methods. Cancer Chemother Pharmacol. 1997G40F293-308. PMIDF9225947

10j Mizuno T, et al. The risk factors of severe acute kidney injury induced by cisplatin. Oncology. 2013G85F364-9. PMIDF24335484


CQ5

ƒVƒXƒvƒ‰ƒ`ƒ“•ŠŠ„“Š—^‚͐táŠQ‚Ė—\–h‚ɐ„§‚ģ‚ę‚é‚ЁH

táŠQ‚Ė—\–h‚ɃVƒXƒvƒ‰ƒ`ƒ“•ŠŠ„“Š—^‚ĖˆÓ‹`‚ÍŠm—§‚ĩ‚Ä‚Ē‚Č‚Ē‚―‚ߐ„§‚ģ‚ę‚Č‚ĒB

„§ƒOƒŒ[ƒh
s‚í‚Č‚Ē‚ą‚Æ‚ð‹­‚­„§‚·‚é
—v@–ņ

ƒVƒXƒvƒ‰ƒ`ƒ“‚Ė•ŠŠ„“Š—^‚É‚æ‚étáŠQ‚Ė—\–h‚ÍŠm—§‚ĩ‚Ä‚Ē‚Č‚Ē‚―‚ߐ„§‚Å‚Ŧ‚Č‚ĒB

”wŒiE–Ú“I

”’‹āŧÜC‚Æ‚­‚ɃVƒXƒvƒ‰ƒ`ƒ“‚ĖtáŠQ‚ɂ́C‚ŧ‚ĖŽå‚―‚é”rŸ•ŠíŠŊ‚Št‚Å‚ ‚é‚ą‚Æ‚ŠŠÖŒW‚ĩ‚Ä‚Ļ‚čC”AŨŠĮ‚Ė‰óŽ€‚ŠŒīˆö‚ƍl‚Ķ‚į‚ę‚Ä‚Ē‚éBtáŠQ‚Ė—\–hEŒyŒļ‚Ė•û–@‚Æ‚ĩ‚āC‘å—Ę•â‰t‚É‚æ‚éhydration ‚ƃ}ƒOƒlƒVƒEƒ€“Š—^‚Š—p‚Ē‚į‚ę‚é‚ą‚Æ‚Š‘―‚ĒBtáŠQ‚Ė—\–hEŒyŒļ‚ð–Ú“I‚Æ‚ĩ‚āC”’‹āŧÜ‚Ė•ŠŠ„“Š—^–@‚ðD‚ņ‚Å—p‚Ē‚éˆãŽt‚Š‚Ē‚é‚ā‚Ė‚ĖCŽ‘ą“Š—^‚Ė‚Ų‚Ī‚Š•ŠŠ„“Š—^‚æ‚č‚ātáŠQ‚Š­‚Č‚Ē‚ą‚Æ‚ðŽĶ‚ĩ‚―ŒĪ‹†‚ŠŽŽ™‚Š‚ņŠģŽŌ‚Å•ņ‚ģ‚ę‚Ä‚Ē‚éB–{e‚ł́CŒŧÝs‚í‚ę‚Ä‚Ē‚étáŠQŒyŒļ‚ðŠú‘Ō‚ĩ‚―ƒVƒXƒvƒ‰ƒ`ƒ“•ŠŠ„“Š—^‚ɂ‚Ē‚āC„§ƒŒƒxƒ‹‚ðŒŸ“Ē‚·‚éB

‰ð@ā

ŒŧÝ‚܂łɁCtáŠQŒyŒļ‚ðŽå—v•]‰ŋ€–Ú‚Æ‚ĩ‚―”’‹āŧÜ•ŠŠ„“Š—^‚ÉŠÖ‚·‚é‘OŒü‚Ŧƒ‰ƒ“ƒ_ƒ€‰ŧ”äŠrŽŽŒą‚͘_•ķ‚Æ‚ĩ‚Ä•ņ‚ģ‚ę‚Ä‚Ē‚Č‚ĒBŽl‚ð‘ΏۂɕŠŠ„“Š—^‚ĖtáŠQ—\–hŒø‰Ę‚𒞐ڌŸØ‚ĩ‚―•ņ‚ā‚Č‚­CƒVƒXƒvƒ‰ƒ`ƒ“•ŠŠ„“Š—^‚ð‘ž‚Ė“Š—^•û–@‚Æ”äŠr‚ĩ‚―ŠÏŽ@ŒĪ‹†‚Š3 Œ‚ ‚é‚Ė‚Ý‚Å‚ ‚éB‚ŧ‚Ė“ā—e‚ÆŒ‹‰Ę‚ðˆČ‰š‚É‚Ü‚Æ‚ß‚éB

Forastiere ‚į‚́CÃ’i20 •Šj‚Ė5 •ŠŠ„“Š—^‚ÆŽ‘ąÃ’i24 ŽžŠÔj‚Ė•ŠŠ„“Š—^“ŊŽm‚ð”äŠr‚ĩ•ņ‚ĩ‚Ä‚Ē‚é1jB‚ą‚ĖŒĪ‹†‚Í“Ščō•”‚Š‚ņŠģŽŌ‚ɑ΂ĩ‚āCƒVƒXƒvƒ‰ƒ`ƒ“30 mg/m2i24 ŽžŠÔjŽ‘ąÃ’‚Ė5 “úŠÔŽ‘ąÃ’‚ð6 —á‚ÉŽĀŽ{‚ĩC‚Ü‚―•Ę‚Ė5 —á‚ɑ΂ĩ‚ăVƒXƒvƒ‰ƒ`ƒ“30 mg/m2i20 •Šj‹}‘ŽÃ’‚Ė5 “úŠÔŠÔŒ‡“Iƒ{[ƒ‰ƒX“Š—^‚ðŽĀŽ{‚ĩ‚āC‘”’‹ā”Z“xC”ņƒ^ƒ“ƒpƒNŒ‹‡Œ^”’‹ā”Z“xC—LŠQŽ–Û‚ð”äŠr‚ĩ‚―‚ā‚Ė‚Å‚ ‚éB‚ŧ‚ĖŒ‹‰ĘC24 ŽžŠÔŽ‘ąÃ’ŒQ‚É‚Ļ‚Ŋ‚éÅ‘å”ņƒ^ƒ“ƒpƒNŒ‹‡Œ^”’‹ā”Z“x‚͈ģ“|“I‚É’á‚Ē‚É‚āŠÖ‚í‚į‚ļC”ņƒ^ƒ“ƒpƒNŒ‹‡Œ^”’‹ā‚Ö‚Ė–\˜IiAUCj‚Í1.5`2 ”{‘å‚Ŧ‚Ē‚ą‚Æ‚Š•ņ‚ģ‚ę‚―B—Տ°“I‚É”FŽŊ‚Å‚Ŧ‚Č‚ĒƒŒƒxƒ‹‚ĖtáŠQ‚ðC”A’†”rŸ•ty‘fNAG ‚ƃAƒ‰ƒjƒ“‚Å‘Š’č‚ĩ•]‰ŋ‚ĩ‚―‚Æ‚ą‚ëC’Ū—͏áŠQC“f‚Ŧ‹CEšq“f‚Æ“Ŋ—l‚ɁCtáŠQ‚É‚Í—žŒQ‚ō·‚Š‚Č‚Đ‚Á‚―B‚ŧ‚ę‚ɑ΂ĩ‚āCœ‘—}§C’áƒ}ƒOƒlƒVƒEƒ€ŒŒĮ‚́C24 ŽžŠÔŽ‘ąÃ’ŒQ‚ō‚•p“x‚ÉŠÏŽ@‚ģ‚ęC‚ą‚Ė‚ą‚Ƃ́C”’‹ā‚Ė‘–\˜I—Ę‚ŠCÅ‘å”Z“x‚æ‚č‚āŠņ—^‚ĩ‚Ä‚Ē‚é‚ą‚Æ‚ŠŽĶī‚ģ‚ę‚é‚Æ‚ĩ‚Ä‚Ē‚éB’˜ŽŌ‚į‚́CŽ‘ą•ŠŠ„“Š—^‚Ė—LŠQŽ–Û‚͗Տ°“I‚É‹–—e‚ģ‚ę‚é”Íáe‚Å‚ ‚Á‚―‚ą‚Æ‚Đ‚įC‚ą‚Ė“Š—^•û–@‚Å‚æ‚č‘å‹K–Í‚ČŽŽŒą‚Šs‚í‚ę‚é‚ą‚Ƃ𐄑E‚ĩ‚Ä‚Ē‚éB‚Č‚ĻC–{ŒĪ‹†‚Í•ŠŠ„“Š—^“ŊŽm‚Ė”äŠr‚Å‚ ‚é‚―‚߁C•ŠŠ„“Š—^‚É‚æ‚郁ƒŠƒbƒg‚Í•s–ū‚Å‚ ‚éB

Ikeda ‚į‚́CˆÝ‚Š‚ņ‚Ļ‚æ‚ŅH“đ‚Š‚ņŠģŽŌ‚ɑ΂·‚é5-FU{ƒVƒXƒvƒ‰ƒ`ƒ“•đ—p—Ö@‚ĖŽŠ“K“Š—^•û–@‚ðŒŸ“Ē‚ĩ•ņ‚ĩ‚Ä‚Ē‚é2jB‚ą‚ĖŒĪ‹†‚Í9 —á‚ĖŠģŽŌ‚ɑ΂·‚é‘S12 ƒTƒCƒNƒ‹‚ĖŽĄ—ÂɂĻ‚Ŋ‚é–ō—Šw“IiAUC ‚Ļ‚æ‚ŅCmaxj‚Č‘Šˆá‚ð”äŠr‚ĩ•]‰ŋ‚ĩ‚Ä‚Ē‚éB”äŠr‚Í3 ŒQ‚ÅŽĀŽ{‚ĩ‚Ä‚Ļ‚čC4 ƒTƒCƒNƒ‹‚Ė80 mg/m2i2 ŽžŠÔjC4 ƒTƒCƒNƒ‹‚Ė20 mg/m2i2 ŽžŠÔj5 “úŠÔ“Š—^C4 ƒTƒCƒNƒ‹‚Ė100 mg/m2i120 ŽžŠÔj“Š—^‚ð‚ŧ‚ę‚ž‚ę”äŠr‚ĩ‚Ä‚Ē‚éB5-FU ‚Ė“Š—^‚ÍŽ‘ą“_“H‚Å800 mg/m2i24 ŽžŠÔj5 “úŠÔ“Š—^‚Æ“ˆę‚ģ‚ę‚Ä‚Ē‚éB’˜ŽŌ‚į‚ÍŽ‘ą“_“H“Š—^•û–@‚ð–ō—Šw“I‚É‚ā‚Á‚Æ‚āŽŠ“K‚Č“Š—^•û–@‚ÆŒ‹˜_‚ÂŊ‚Ä‚Ē‚é‚ŠC—LŠQŽ–Û‚ɂ‚Ē‚Ä‚Í‚ŧ‚Ė—DˆĘŦ‚ð”F‚ß‚Ä‚Ē‚Č‚ĒB

‚Ü‚―‚‹ī‚į‚́CƒVƒXƒvƒ‰ƒ`ƒ““Š—^•û–@‚Ė‘ŠˆŲi5 •ŠŠ„“Š—^C24 ŽžŠÔŽ‘ą“_“HC12 ŽžŠÔŽ‘ą“_“HC6 ŽžŠÔŽ‘ą“_“Hj‚É‚æ‚é‘Ė“ā“Ū‘Ô‚Ļ‚æ‚ŅtáŠQ‚ð”äŠrŒŸ“Ē‚ĩ‚Ä‚Ē‚é‚ŠC—Տ°“I—LŠQŽ–Û‚ɍ·‚Í‚Ý‚į‚ę‚Ä‚Ē‚Č‚Ē3jB

ã‹LCŽO‚‚ĖŒĪ‹†‚ŁC“Š—^•û–@‚É‚æ‚étáŠQ‚ɍ·‚Í‚Č‚­C•ŠŠ„“Š—^•û–@‚ðÏ‹É“I‚ɐ„‘E‚·‚é‚ɂ͍Š‹’‚ÉŒ‡‚Ŋ‚éB‚ĩ‚―‚Š‚Á‚āCŒŧŽž“_‚Å‚Í“KØ‚ɃfƒUƒCƒ“‚ģ‚ę‚―ŒĪ‹†‚Š‚Č‚Ē‚―‚߁CtáŠQ—\–h–Ú“I‚ĖƒVƒXƒvƒ‰ƒ`ƒ“•ŠŠ„“Š—^‚ðÏ‹É“I‚ɐ„§‚·‚鍊‹’‚Í‚Č‚Ē‚Æ‚Ē‚Ķ‚éB‚―‚ū‚ĩNational Comprehensive Cancer NetworkiNCCNjƒKƒCƒhƒ‰ƒCƒ“2014 ‚ĖäNãũ‚Š‚ņ‚Ė€‚É‚Ļ‚Ē‚āCt‹@”\‚Š‹ŦŠEˆæ‚ ‚é‚Ē‚͍ŏŽŒĀ‚ĖáŠQ‚Ė‚ ‚éĮ—á‚É‚Ļ‚Ē‚ẮC•ŠŠ„“Š—^i‹ï‘ĖˆÄ‚Æ‚ĩ‚Ä35 mg/m2‚Ėday 1Cday 2 “Š—^‚ ‚é‚Ē‚Íday 1Cday 8 “Š—^j‚ðl—ķ‚·‚é‚ą‚Æ‚Æ‹LÚ‚ģ‚ę‚Ä‚Ē‚é4jB‚ĩ‚Đ‚ĩ‚Č‚Š‚įC‚ą‚Ė•ŠŠ„“Š—^‚ÉŠÖ‚·‚éˆø—p•ķŒĢ‚ÍŽĶ‚ģ‚ę‚Ä‚Ē‚Č‚ĒB‚ŧ‚ĩ‚Ä•ŠŠ„“Š—^‚É”š‚ĪŽĄ—ÃŒø‰Ę‚ÉŠÖ‚ĩ‚Ä‚ā•s–ū‚Æ‚ģ‚ę‚Ä‚Ē‚éB

‚Č‚ĻtáŠQ‚Ė—\–hEŒyŒļ‚É‚ÍŽ‘ą“Š—^‚ŠˆĀ‘S‚Æ‚Ē‚ĪŒĐ‰ð‚Š‚ ‚éBErdlenbruch ‚į‚́CŽŽ™4 —á‚Ėœ“ũŽîŠģŽŌ‚É120 mg/m2‚ĖƒVƒXƒvƒ‰ƒ`ƒ“‚ð72 ŽžŠÔ‚Đ‚Ŋ‚ÄŽ‘ą“Š—^‚ĩ‚―ŒQ‚ƁCŽŽ™6 —á‚Ė‘‰čŽîŠģŽŌ‚É40 mg/m2‚ð3 “úŠÔ‚É‚í‚―‚č‚ŧ‚ę‚ž‚ę1 ŽžŠÔ‚Å‹}‘ŽÃ’‚ĩ‚―•ŠŠ„“Š—^ŒQ‚Ė‘Ė“ā“Ū‘ԁCtáŠQ‚ð”äŠr‚ĩ‚―5jB•ŠŠ„“Š—^ŒQ‚ł́CƒAƒ‹ƒuƒ~ƒ“‚ÉŒ‹‡‚ĩ‚Ä‚Ē‚Č‚Ē—V—Ģ”’‹ā”Z“x‚ĖÅ‘å’l‚Š19 ”{‚‚­CGFR ‚ĖÅ’á’l‚ÍŽ‘ą“Š—^ŒQ‚É‚­‚į‚Ũ’á‚­C1 ”NˆČ“ā‚ĖtáŠQ‚āŽ‘ą‚·‚é—Ķ‚Š‚‚Đ‚Á‚―B’˜ŽŌ‚į‚́CŽ‘ą“Š—^–@‚Í•ŠŠ„“Š—^–@‚É‚­‚į‚Ũ‚ĐtáŠQ‚Š­‚Č‚Ē‚ÆŒ‹˜_‚ÂŊ‚Ä‚Ē‚éB

yŽQl•ķŒĢz

1j Forastiere AA, et al. Pharmacokinetic and toxicity evaluation of five-day continuous infusion versus intermittent bolus cis-diamminedichloroplatinumiⅡjin head and neck cancer patients.Cancer Res. 1988G48F3869-74. PMIDF3378222

2j Ikeda K, et al. Pharmacokinetics of cisplatin in combined cisplatin and 5-fluorouracil therapyFa comparative study of three different schedules of cisplatin administration. Jpn J Clin Oncol. 1998G28F168-75. PMIDF9614438

3j ‚‹ī˜N‚Ų‚ЁDCisplatin “Š—^•û–@‚Ėˆá‚Ē‚É‚æ‚é‘Ė“ā“Ū‘ԂƐtáŠQDŠā‚ƉŧŠw—Ö@D1987G14F2944-50.

4j National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Bladder Cancer Version 2. 2014. BL-G 1 of 3.@

5j Erdlenbruch B, et al. Cisplatin nephrotoxicity in children after continuous 72-h and 3x1-h infusions. Pediatr Nephrol. 2001G16F586-93. PMIDF11465809


CQ6

ƒVƒXƒvƒ‰ƒ`ƒ““Š—^Žž‚Ė•â‰ti3 L/“úˆČãj‚͐táŠQ‚ðŒyŒļ‚·‚é‚―‚߂ɐ„§‚ģ‚ę‚é‚ЁH

ƒVƒXƒvƒ‰ƒ`ƒ““Š—^Žž‚Ė•â‰ti3 L/“úˆČãj‚́CtáŠQ‚ðŒyŒļ‚·‚é‚―‚߂ɐ„§‚ģ‚ę‚éB

„§ƒOƒŒ[ƒh
s‚Ī‚ą‚Æ‚ð‹­‚­„§‚·‚é
—v@–ņ

‘O—Տ°i“Ū•ĻŽĀŒąj’iŠK‚ŃVƒXƒvƒ‰ƒ`ƒ“‚Ėt“ŐŦ‚ŠŽw“E‚ģ‚ę‚―‚―‚߁C“–‰‚Đ‚į•â‰t‚ðŠÜ‚ÞŽxŽ—Ö@‚ð—p‚Ē‚ÄŠJ”­‚Š‚Č‚ģ‚ę‚―B‚æ‚Á‚ă‰ƒ“ƒ_ƒ€‰ŧ”äŠrŽŽŒą‚Č‚Į‚ĖŽŋ‚Ė‚‚ĒƒGƒrƒfƒ“ƒX‚Í‘ķÝ‚ĩ‚Č‚Ē‚ŠCƒVƒXƒvƒ‰ƒ`ƒ““Š—^Žž‚Ė•â‰t‚Í‹­‚­„§‚ģ‚ę‚éB

”wŒiE–Ú“I

”’‹āŧÜ‚Í‚ģ‚Ü‚ī‚Ü‚Č‚Š‚ņ‚ÉŽg—p‚ģ‚ę‚ét”rŸ•Œ^‚ĖR‚Š‚ņ–ō‚Å‚ ‚čCt“ŐŦ‚ð—L‚·‚é‚ą‚Æ‚Š’m‚į‚ę‚Ä‚Ē‚éB‚Č‚Đ‚Å‚āƒVƒXƒvƒ‰ƒ`ƒ“‚Ėt“ŐŦ‚Š‹­‚Ē‚―‚߁C‚ģ‚Ü‚ī‚Ü‚ČŒŸ“Ē‚Š‚Č‚ģ‚ę‚Ä‚Ē‚éBt“ŐŦ‚Ė—\–hô‚Æ‚ĩ‚Ä‚Í•â‰tC—˜”A–ō‚Ė“Š—^‚ŠŽå‚―‚éŽč’i‚ƍl‚Ķ‚į‚ę‚Ä‚Ļ‚čC•â‰t—Ę‚Ė‰Į‘―‚â—˜”A–ō‚Ė“Š—^‚Ė—L–ģ‚ɂ‚Ē‚Ä‚Í•Ę‚ĖCQ ‚Š‚ ‚é‚―‚ß‚ą‚ą‚ł͐G‚ę‚Č‚ĒB

‰ð@ā

–{CQ ‚É“š‚Ķ‚é‚―‚߂ɁC–{—ˆ‚̓qƒg‚ð‘ΏۂƂĩ‚―ƒVƒXƒvƒ‰ƒ`ƒ““Š—^Žž‚Ė•â‰t‚Ė—L–ģ‚ðƒ‰ƒ“ƒ_ƒ€‰ŧ‚ĩ‚―”äŠrŽŽŒą‚Š•K—v‚Å‚ ‚é‚ŠC‚ŧ‚Ė‚æ‚Ī‚ČŽŽŒą‚͍Ą‰ņ‚ĖŒŸõŽŪ‚Å‚Í”­ŒĐ‚ĩ“ū‚Č‚Đ‚Á‚―B‘ķÝ‚·‚éŠÖ˜A•ķŒĢ‚Ė‘―‚­‚͐táŠQ‚ð˜_‚ķ‚―ƒŒƒrƒ…[‚Å‚ ‚čC‘ã•\“I‚ČƒŒƒrƒ…[1j‚Å‚Í•â‰t„§‚ĖŠ‹’‚Æ‚ĩ‚āC‘ΏƌQC“Š—^‘O•â‰tŒQCƒ}ƒ“ƒjƒg[ƒ‹“Š—^ŒQ‚Ė3 ŒQ‚ðŒŸ“Ē‚ĩ‚ÄŒã2 ŒQ‚Őt“ŐŦ‚ŠŒyŒļ‚ĩ‚―“Ū•ĻŽĀŒą2j‚ðˆø—p‚ĩ‚Ä‚Ē‚éB‘ž‚ĖƒŒƒrƒ…[‚Å‚āC•â‰t‚Ļ‚æ‚Ņ—˜”A–ō‚É‚æ‚é‹­§—˜”A‚𐄏§‚ĩ‚Ä‚Ē‚é‚ā‚Ė‚Š‘―‚ĒBƒVƒXƒvƒ‰ƒ`ƒ“‚ĖŠJ”­‚Šs‚í‚ę‚―‚Ė‚Í1970 ”N‘ã‚Å‚ ‚čCŒŧÝ‚Æ‚ÍŽĄ—Ö@ŠJ”­‚Ė•û–@˜_‚ŠˆŲ‚Č‚é‚ą‚ƁC‚ЂŠJ”­‘Šú‚ɐt“ŐŦ‚Ė‘ķÝ‚Š”FŽŊ‚ģ‚ę‚Ä‚Ē‚―‚ą‚Æ‚Đ‚įCƒqƒg‚ÅŒŸØŽŽŒą‚Šs‚í‚ę‚Ä‚Ē‚Č‚Ē‚ą‚Æ‚ÍŽ~‚Þ‚ð“ū‚Č‚Ē‚ƍl‚Ķ‚į‚ę‚éBŒ‹‰Ę‚Æ‚ĩ‚āCƒGƒrƒfƒ“ƒX‚ĖŽŋ‚Í”ņí‚É’á‚Ē‚Æ”ŧ’f‚ģ‚ę‚éiDFŒø‰Ę‚Ė„’č’l‚Š‚Ų‚Æ‚ņ‚ĮŠmM‚Å‚Ŧ‚Č‚ĒjB

Œŧ‘ķ‚·‚é‚ģ‚Ü‚ī‚Ü‚Č‚Š‚ņ–ō•Ļ—Ö@‚ĖƒGƒrƒfƒ“ƒX‚É‚Ļ‚Ē‚āCƒVƒXƒvƒ‰ƒ`ƒ“‚ð—p‚Ē‚éÛ‚É‚Í’Ęí•â‰t‚ðs‚Ī‚æ‚ĪŽĀŽ{Œv‰æ‚É‹K’č‚ģ‚ę‚Ä‚Ē‚éB‚ŧ‚Ė‘ž‚Ė”’‹āŧÜiƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚Č‚Įj‚ł́C’ʏí•â‰t‚ÉŠÖ‚ĩ‚Ä‚Í‚ŧ‚Ė‚æ‚Ī‚É‹K’č‚ģ‚ę‚Ä‚Ē‚Č‚ĒB“ú–{‚É‚Ļ‚Ŋ‚éƒVƒXƒvƒ‰ƒ`ƒ“‚Ė“Y•t•ķ‘‚ł́C—p–@E—p—Ę‚Ė€‚É“Š—^‘OC“Š—^ŽžC“Š—^Œã‚É•â‰t‚ðs‚Ī‚æ‚Ī‹LÚ‚ģ‚ę‚Ä‚Ē‚é‚ŠCƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚É‚Í‚ŧ‚Ė‚æ‚Ī‚Č‹LÚ‚Í‚Č‚ĒB•Ä‘‚Å‚āƒVƒXƒvƒ‰ƒ`ƒ“‚Ė“Y•t•ķ‘‚ɂ́C•â‰t‚ðs‚Ī‚æ‚Ī‹LÚ‚ģ‚ę‚Ä‚Ē‚é‚ŠCƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚É‚Í‚ŧ‚Ė‚æ‚Ī‚Č‹LÚ‚Í‚Č‚ĒiƒVƒXƒvƒ‰ƒ`ƒ“‚ƈŲ‚Č‚č’ʏí‘å—Ę•â‰t‚â‹­§—˜”A‚͍s‚í‚ę‚Č‚ĒC‚Æ–ū‹L‚ģ‚ę‚Ä‚Ē‚éjB

ã‹L‚Ļ‚æ‚Ņ—˜‰v/•s—˜‰v‚Ėƒoƒ‰ƒ“ƒX‚ðl—ķ‚ĩ‚Đ„§“x‚ðŒŸ“Ē‚·‚é‚ƁCƒVƒXƒvƒ‰ƒ`ƒ“‚Ė“Š—^Žž‚É‚Í•â‰t‚Í‹­‚­„§‚ģ‚ę‚éBƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚ðŠÜ‚ß‚―‘ž‚Ė”’‹āŧÜ‚Ė“Š—^Žž‚É‚Í•â‰t‚͐„§‚ģ‚ę‚Č‚ĒB‚Č‚ĻCƒVƒXƒvƒ‰ƒ`ƒ““Š—^Žž‚Ė•â‰t‚ɂ‚Ē‚ẮCķ—H‰–…‚Ü‚―‚Í1/2 ķ—H‰–…‚ðCƒVƒXƒvƒ‰ƒ`ƒ““Š—^‘O‚Í2 L ‘OŒãCƒVƒXƒvƒ‰ƒ`ƒ““Š—^Œã‚Í 1 L ’ö“xˆČã“Š—^‚·‚é‚ą‚Æ‚Š‚Đ‚Â‚Ä‚Í‚æ‚­s‚í‚ę‚―B‚ą‚Ė•â‰t—Ę‚ð­‚Č‚­‚ĩCŒoŒû•â…‚Č‚Į‚ðŠˆ—p‚·‚é‚Ē‚í‚ä‚égshort hydrationh‚ɂ‚Ē‚Ä‚ÍCQ7 ‚ðŽQÆ‚Ė‚ą‚ƁB

yŽQl•ķŒĢz

1j Finley RS, et al. Cisplatin nephrotoxicityFa summary of preventative interventions. Drug Intell Clin Pharm. 1985G19F362-7. PMIDF3891281

2j Cvitkovic E, et al. Improvement of cis-dichlorodiammineplatinumiNSC 119875jFtherapeutic index in an animal model. Cancer. 1977G39F1357-61. PMIDF856436


CQ7

ƒVƒXƒvƒ‰ƒ`ƒ““Š—^Žž‚Ėshort hydration ‚͐„§‚ģ‚ę‚é‚ЁH

ŠO—ˆ‚ŃVƒXƒvƒ‰ƒ`ƒ“‚ð“Š—^‚·‚éÛ‚́Ct‹@”\EPSE”N—î‚ðl—ķ‚ĩ‚―‚Ī‚Ķ‚Åshort hydration ‚𐄏§‚·‚éB‚―‚ū‚ĩCshort hydration ‚ðˆĀ‘S‚ɍs‚Ī‚ɂ́C\•Š‚ČŒoŒû…•Š•â‹‹‚Æ”A—ĘŠm•Û‚Š•K{‚Å‚ ‚čC‰ŧŠw—Ö@Ž{s“–“ú‚Đ‚į3 “ú–ڂ܂ŁCHŽ–‚Č‚Į’ʏí‚ĖÛŽæ—ʂɉÁ‚Ķ‚āC1 “ú‚ ‚―‚č1,000 mL ’ö“x‚Ė’Į‰Á•â‹‹‚Š‰Â”\‚ȏĮ—á‚Š‘ÎÛ‚Æ‚Č‚éB‚Ü‚―CŒoŒû…•Š•â‰t‚Š•s\•Š‚Æ‚Č‚Á‚―ę‡Cv‘Ž‚É“_“H‚É‚æ‚鐅•Š•â‹‹‚Šs‚Ķ‚éŠÂ‹Ŧ‚ŠŪ‚Ķ‚į‚ę‚Ä‚Ē‚é‚ą‚Æ‚Š•K—v‚Å‚ ‚éB

„§ƒOƒŒ[ƒh
s‚Ī‚ą‚Æ‚ðŽã‚­„§‚·‚éi’ņˆÄ‚·‚éj
—v@–ņ

ƒVƒXƒvƒ‰ƒ`ƒ““Š—^Žž‚́Ct‹@”\EPSE”N—î‚ðl—ķ‚ĩ‚―‚Ī‚Ķ‚Åshort hydration ‚𐄏§‚·‚éB‚―‚ū‚ĩCshort hydration ‚ðˆĀ‘S‚ɍs‚Ī‚ɂ́C\•Š‚ČŒoŒû…•Š•â‹‹‚Š•K{‚Å‚ ‚čC‰ŧŠw—Ö@Ž{s“–“ú‚Đ‚į3 “ú–ڂ܂ŁCHŽ–‚Č‚Į’ʏí‚ĖÛŽæ—ʂɉÁ‚Ķ‚āC1 “ú‚ ‚―‚č1,000 mL ’ö“x‚Ė’Į‰Á•â‹‹‚Š‰Â”\‚ȏĮ—á‚Š‘ÎÛ‚Æ‚Č‚éB‚Ü‚―CŒoŒû…•Š•â‹‹‚Š•s\•Š‚Æ‚Č‚Á‚―ę‡Cv‘Ž‚É“_“H‚É‚æ‚鐅•Š•â‹‹‚Šs‚Ķ‚éŠÂ‹Ŧ‚ŠŪ‚Ķ‚į‚ę‚Ä‚Ē‚é‚ą‚Æ‚Š•K—v‚Å‚ ‚éB‚ģ‚į‚ɁCshort hydration ‚ðs‚Ī‚Ī‚Ķ‚ŁC—˜”A–ōiƒ}ƒ“ƒjƒg[ƒ‹‚Ü‚―‚̓tƒƒZƒ~ƒhj‚É‚æ‚é”A—Ę‚ĖŠm•Û‚ƃ}ƒOƒlƒVƒEƒ€CƒJƒŠƒEƒ€‚Ė•â‹‹CŒŒī“d‰ðŽŋ‚ĖŠm”F‚ā•K—v‚Å‚ ‚éB

”wŒiE–Ú“I

ƒVƒXƒvƒ‰ƒ`ƒ“‚Ė“Š—^‘OŒã‚ɂ́CtáŠQ—\–h‚Ė‚―‚ßhydration ‚·‚é‚ą‚Æ‚Š’č‚ß‚į‚ę‚Ä‚Ē‚éB‚í‚Š‘‚ł́CƒVƒXƒvƒ‰ƒ`ƒ““Š—^‘OŒã‚É‚ŧ‚ę‚ž‚ę4 ŽžŠÔˆČã‚Đ‚Ŋ‚Ä1,000`2,000 mL ‚Ė•â‰t“Š—^‚ƁC500`1,000 mL ˆČã‚Ė—A‰t‚ÉŠóŽß‚ĩ‚―ƒVƒXƒvƒ‰ƒ`ƒ“‚ð2 ŽžŠÔˆČã‚Đ‚Ŋ‚Ä“Š—^‚·‚é‚ą‚Æ‚Æ‚ģ‚ę‚Ä‚Ē‚éB‚ĩ‚Đ‚ĩC‚ą‚Ėhydration –@‚Í’·ŽžŠÔ‚É‚Ļ‚æ‚Ô‚―‚߁C“ü‰@‚·‚é•K—v‚Š‚ ‚éBˆČ‘O‚æ‚čCƒVƒXƒvƒ‰ƒ`ƒ“‚É‚æ‚étáŠQ—\–h‚Ėhydration –@‚ðŒŸ“Ē‚ĩ‚―•ņ‚Š‚Ē‚­‚‚ЂȂģ‚ę‚Ä‚Ē‚éB‚ŧ‚ą‚ōĄ‰ņC2,000`2,500 mL ‚Ė•â‰t‚ð4 ŽžŠÔ’ö“x‚Å“Š—^‚·‚éshort hydration –@‚ĖˆĀ‘SŦ‚ɂ‚Ē‚Ä•]‰ŋ‚ĩ‚―B

‰ð@ā

‚—p—ĘƒVƒXƒvƒ‰ƒ`ƒ“i†75 mg/m2j‚ðshort hydration –@‚Å“Š—^‚ĩ‚―Û‚ĖˆĀ‘SŦ‚ɂ‚Ē‚āC2007 ”N‚ÉTiseo ‚į1j‚Š2 Ž{Ý‚É‚Ļ‚Ŋ‚éŒã‚ëŒü‚ŦŠÏŽ@ŒĪ‹†‚ð•ņ‚ĩ‚Ä‚Ē‚éB‚ą‚ę‚É‚æ‚é‚ƁCƒVƒXƒvƒ‰ƒ`ƒ““Š—^“ú‚ÉŒv4 ŽžŠÔ‚Đ‚Ŋ‚Ä2,000 mL ’ö“x‚Ėķ—H‰–‰t‚ƃtƒƒZƒ~ƒh“Š—^‚ðŽĀŽ{‚ĩ‚―‚Æ‚ą‚ëCt“ŐŦ‚É‚æ‚é‰ŧŠw—Ö@’†Ž~‚Š107 —á’†5 —ái4.6“j‚Š”­ķ‚ĩC‚ą‚Ė‚Ī‚ŋ2 —á‚ŠNational Cancer Institute ‚ĖCommon Toxicity Criteria Grade 2 ‚Ėt“ŐŦ‚Å‚ ‚Á‚―B‚í‚Š‘‚Å‚āHorinouchi ‚į2jCHotta ‚į3j‚Š‚ŧ‚ę‚ž‚ęƒVƒXƒvƒ‰ƒ`ƒ“‚ð75 mg/m2ˆČãC60 mg/m2ˆČã‚Å“Š—^‚ĩ‚―ŠģŽŌ‚ð‘ΏۂɏŽ‹K–Í‘OŒü‚ŦŽŽŒą‚ðŽĀŽ{‚ĩ‚Ä‚Ē‚éBƒJƒŠƒEƒ€Cƒ}ƒOƒlƒVƒEƒ€Cƒ}ƒ“ƒjƒg[ƒ‹‚Ė“Š—^‚ð‘g‚ݍž‚ņ‚ūshort hydration –@‚ŁCŒŒīCr ’l‚ŠƒOƒŒ[ƒh2iCommon Terminology Criteria for Adverse Events ver. 4.0 Šî€”͈͏ãŒĀ‚ÉŠî‚­jˆČã‚Æ‚Č‚Á‚―Š„‡‚́C‚ŧ‚ę‚ž‚ę2.2“i1/44 ljC0“i0/46 lj‚Å‚ ‚Á‚―B‚ŧ‚Ė‘žC•]‰ŋ‚ĩ‚―‚·‚Ũ‚Ä‚Ė•ķŒĢ4-10j‚É‚Ļ‚Ē‚āCshort hydration –@‚Š]—ˆ‚Ėhydration –@‚É‚­‚į‚Ũ‚ĐtáŠQ”­Œŧ—Ķ‚Ė‘‰Á‚Č‚­CˆĀ‘S‚ÉŽĀŽ{‰Â”\‚Å‚ ‚é‚ÆŒ‹˜_‚ÂŊ‚Ä‚Ļ‚čCŒ‹‰Ę‚ɈęŠŅŦ‚Š‚ ‚é‚Æ”ŧ’f‚ĩ‚―BĄ‰ņ•]‰ŋ‚ĩ‚―short hydration –@‚́C•â‰t‘—Ę–ņ1,600`2,500 mL‚ð4 ŽžŠÔ’ö“x‚Đ‚Ŋ‚Ä“Š—^‚ĩ‚Ä‚Ļ‚čCƒJƒŠƒEƒ€Cƒ}ƒOƒlƒVƒEƒ€‚Ė•â‹‹‚Æ—˜”A–ōiƒtƒƒZƒ~ƒh‚âƒ}ƒ“ƒjƒg[ƒ‹j‚É‚æ‚é”A—ĘŠm•Û‚ðs‚Á‚Ä‚Ē‚―Bˆę•ûC•Ä‘‚ĖNational Comprehensive Cancer NetworkiNCCNj‚ł́C‘―‚­‚Ė‚Š‚ņŽî‚É‚Ļ‚Ē‚ăVƒXƒvƒ‰ƒ`ƒ“‚Ė“Š—^‘OŒã‚ÉŒv1,000`3,000 mL‚ð250`500 mL/Žž‚Å“Š—^‚·‚é‰ŧŠw—Ö@ƒI[ƒ_[ƒeƒ“ƒvƒŒ[ƒg‚ðŽĶ‚ĩ‚Ä‚Ē‚é11jB‚Ü‚―C‚í‚Š‘‚́C“ú–{”xŠāŠw‰ïE“ú–{—Տ°Žîᇊw‰ï‚æ‚čshort hydration –@‚ɂ‚Ē‚ÄŒū‹y‚ĩ‚―uŽčˆø‚Ŧv‚ŠėŽ‚ģ‚ę‚Ä‚Ļ‚čC‘ΏۊģŽŌ‚ðŒĀ’č‚·‚é‚ą‚ƂňĀ‘S‚É“Š—^‰Â”\‚Å‚ ‚é‚ƍl‚Ķ‚į‚ę‚é12jB‘ΏۊģŽŌ‚́C”N—î75 Î–Ē–žCŒŒīCr ’l‚ŠŽ{ÝŠî€’lˆČ‰šCCcr†60 mL/•ŠCEastern Cooperative Oncology Group scaleiECOGj‚ĖPS 0`1C‹đ…E• …’™—Ŋ‚Š‚Č‚­C1 ŽžŠÔ‚ ‚―‚č500 mL ’ö“x‚Ė•â‰t‚É‘Ï‚Ķ‚Ī‚éS‹@”\iS‘Ÿ’ī‰đ”gŒŸļ‚ɂčķŽš‹ėo—Ķ†60“‚Č‚Įj‚Å‚ ‚é‚ą‚ƁC“KØ‚Ȑ§“f—Ö@‚ðŽĀŽ{‚ĩCƒVƒXƒvƒ‰ƒ`ƒ““Š—^“ú‚Đ‚į3 “úŠÔ‚Í1,000 mL/“ú’ö“x‚ĖŒoŒû•â‹‹‚Š‰Â”\‚Å‚ ‚é‚ą‚Æ‚Č‚Į‚ŠðŒ‚É‚Č‚éB‚ŧ‚Ė‚―‚߁C•aŽŊ‚Š—ĮD‚ŃAƒhƒqƒAƒ‰ƒ“ƒX‚Š’S•Û‚ģ‚ę‚Ä‚Ē‚é‚ą‚Æ‚āŠģŽŌ‘I’č‚ĖÛCd—v‚É‚Č‚éB‚Ü‚―Cd“Ä‚Č•›ė—p‚Ė”­Œŧ‚␅•ŠÛŽæ‚Š•s\•Š‚Æ‚Č‚Á‚―ę‡‚ɐv‘Ž‚ɑΉž‚Å‚Ŧ‚éŽ{Ý‚ōs‚Ī‚Ũ‚Ŧ‚Å‚ ‚éBƒGƒrƒfƒ“ƒX‘‘Ė‚Ė•]‰ŋ‚ɂ‚Ē‚ẮC‘ΏیĪ‹†‚Š‚·‚Ũ‚ÄŠÏŽ@ŒĪ‹†‚Å‚ ‚čCCiŽãj‚Đ‚įŠJŽn‚ĩ‚―B•]‰ŋ‚ð‰š‚°‚鍀–Ú‚Å‚ ‚éƒoƒCƒAƒXƒŠƒXƒNC”ņ’žÚŦC”ņˆęŠŅŦC•sģŠmCo”ŃoƒCƒAƒX‚ÉŠÖ‚ĩ‚Đ[‚Č–â‘č‚Í‚Č‚Ē‚Æ”ŧ’f‚ĩ‚―B‚Ü‚―C•]‰ŋ‚ð‚ ‚°‚鍀–Ú‚Å‚ ‚é‰î“ü‚É‚æ‚éŒø‰ĘC—p—Ę-”―‰žŒų”zCŒð—ˆöŽq‚ā‚ ‚Ä‚Í‚Ü‚į‚Č‚Ē‚Æ”ŧ’f‚ĩCƒGƒrƒfƒ“ƒX‘‘Ė‚ÍCiŽãj‚Æ‚ĩ‚―B

yŽQl•ķŒĢz

1j Tiseo M, et al. Short hydration regimen and nephrotoxicity of intermediate to high-dose cisplatin-based chemotherapy for outpatient treatment in lung cancer and mesothelioma. Tumori. 2007G93F138-44. PMIDF17557559

2j Horinouchi H, et al. Short hydration in chemotherapy containing cisplatini≥75 mg/m2jfor patients with lung cancerFa prospective study. Jpn J Clin Oncol. 2013G43F1105-9. PMIDF24006505

3j Hotta K, et al. Reappraisal of short-term low-volume hydration in cisplatin-based chemotherapyFresults of a prospective feasibility study in advanced lung cancer in the Okayama Lung Cancer Study Group Trial 1002. Jpn J Clin Oncol. 2013G43F1115-23. PMIDF24082005

4j ŠÝ–{•ü”T‚Ų‚ЁDisÄ”­ˆÝŠā‚ĖSP —Ö@‚É‚Ļ‚Ŋ‚éŠO—ˆCDDP “Š—^‚Ė”F—eŦ‚ÉŠÖ‚·‚錟“ĒDŠā‚ƉŧŠw—Ö@D2012G39F2304-6D

5j `–ū“o‚Ų‚ЁDShort Hydrationi4 ŽžŠÔˆČ“āj‚ð—p‚Ē‚―ƒVƒXƒvƒ‰ƒ`ƒ“ŠO—ˆ“Š—^‚ĖŒŸ“ĒDŠā‚ƉŧŠw—Ö@D2012G39F1385-8D

6j Furukawa N, et al. Use of high-dose cisplatin with aprepitant in an outpatient setting. Eur J Cancer CareiEnglj. 2012G21F436-41. PMIDF21883567

7j Giaccone G, et al. Disorders of serum electrolytes and renal function in patients treated with cis-platinum on an outpatient basis. Eur J Cancer Clin Oncol. 1985G21F433-7. PMIDF4040022

8j Lavolé A, et al. Routine administration of a single dose of cisplatin ≥75 mg/m2 after short hydration in an outpatient lung-cancer clinic. Bull Cancer. 2012G99FE43-8. PMIDF22450449

9j Vogl SE, et al. Toxicity of cis-diamminedichloroplatinum Ⅱ given in a two-hour outpatient regimen of diuresis and hydration. Cancer. 1980G45F11-5. PMIDF7188679

10j Vogl SE, et al. Safe and effective two-hour outpatient regimen of hydration and diuresis for the administration of cis-diamminedichloroplatinumiⅡj. Eur J Cancer. 1981G17F345-50. PMIDF6790287

11j National Comprehensive Cancer Network. NCCN Chemotherapy Order TemplatesiNCCN Templates®j

12j “ú–{”xŠāŠw‰ïƒKƒCƒhƒ‰ƒCƒ“ŒŸ“ĒˆÏˆõ‰ïC“ú–{—Տ°Žîᇊw‰ïƒKƒCƒhƒ‰ƒCƒ“ˆÏˆõ‰ïDƒVƒXƒvƒ‰ƒ`ƒ““Š—^‚É‚Ļ‚Ŋ‚éƒVƒ‡[ƒgƒnƒCƒhƒŒ[ƒVƒ‡ƒ“–@‚ĖŽčˆø‚ŦD2015 ”N8 ŒŽD


CQ8

—˜”A–ō“Š—^‚̓VƒXƒvƒ‰ƒ`ƒ“‚É‚æ‚étáŠQ‚Ė—\–h‚ɐ„§‚ģ‚ę‚é‚ЁH

—˜”A–ō“Š—^‚̓VƒXƒvƒ‰ƒ`ƒ“‚É‚æ‚étáŠQ‚Ė—\–h‚É–ūŠm‚Ȑ„§‚Š‚Å‚Ŧ‚Č‚ĒBŽ‹K–Í‚Čƒ‰ƒ“ƒ_ƒ€‰ŧ”äŠrŽŽŒą‚É‚Ļ‚Ē‚Ä‚ŧ‚ĖŒø‰Ę‚ŠØ–ū‚ģ‚ę‚Ä‚Ē‚Č‚Ē‚―‚߁C„§‚·‚é‚ū‚Ŋ‚ĖŠ‹’‚Š‚Č‚ĒB‚―‚ū‚ĩC—˜”A–ō“Š—^‚Í1970 ”N‘ã‚Đ‚įL‚­s‚í‚ę‚Ä‚Ē‚éƒVƒXƒvƒ‰ƒ`ƒ““Š—^Žž‚ĖtáŠQ—\–h–@‚Å‚ ‚čCƒVƒXƒvƒ‰ƒ`ƒ“‚ðŠÜ‚ÞŽĄ—Ö@‚Ė‘å‹K–Í‚Č—Õ°ŽŽŒą‚É‚Ļ‚Ē‚āC–{–@‚ð—p‚Ē‚―‚Ī‚Ķ‚Å‚Ė—LŒøŦCˆĀ‘SŦ‚ŠŽĶ‚ģ‚ę‚Ä‚Ē‚éB‚ĩ‚―‚Š‚Á‚āC–{–@‚ð”Û’č‚·‚鍊‹’‚ā‚Č‚ĒB

„§ƒOƒŒ[ƒh
s‚Ī‚ą‚Æ‚ðŽã‚­„§‚·‚éi’ņˆÄ‚·‚éj
—v@–ņ

—˜”A–ō“Š—^‚̓VƒXƒvƒ‰ƒ`ƒ“‚É‚æ‚étáŠQ‚Ė—\–h‚É–ūŠm‚Ȑ„§‚Š‚Å‚Ŧ‚Č‚ĒBŽ‹K–Í‚Čƒ‰ƒ“ƒ_ƒ€‰ŧ”äŠrŽŽŒą‚É‚Ļ‚Ē‚Ä‚ŧ‚ĖŒø‰Ę‚ŠØ–ū‚ģ‚ę‚Ä‚Ē‚Č‚Ē‚―‚߁C„§‚·‚é‚ū‚Ŋ‚ĖŠ‹’‚Š‚Č‚ĒB‚―‚ū‚ĩC—˜”A–ō“Š—^‚Í1970 ”N‘ã‚Đ‚įL‚­s‚í‚ę‚Ä‚Ē‚éƒVƒXƒvƒ‰ƒ`ƒ““Š—^Žž‚ĖtáŠQ—\–h–@‚Å‚ ‚čC”’‹āŧÜ‚ðŠÜ‚ÞŽĄ—Ö@‚Ė‘å‹K–Í‚Č—Õ°ŽŽŒą‚É‚Ļ‚Ē‚āC–{–@‚ð—p‚Ē‚―‚Ī‚Ķ‚Å‚Ė—LŒøŦCˆĀ‘SŦ‚ŠŽĶ‚ģ‚ę‚Ä‚Ē‚éB‚ĩ‚―‚Š‚Á‚āC–{–@‚ð”Û’č‚·‚鍊‹’‚ā‚Č‚ĒB

”wŒiE–Ú“I

1970 ”N‘ã‚É•â‰t‚Ļ‚æ‚Ņ—˜”A–ō‚ð—p‚Ē‚é‚ą‚Ƃō‚—p—Ę‚ĖƒVƒXƒvƒ‰ƒ`ƒ““Š—^‚Š‰Â”\‚É‚Č‚é‚ą‚Æ‚Š•ņ‚ģ‚ę‚ÄˆČ—ˆCƒVƒXƒvƒ‰ƒ`ƒ““Š—^‚É‚Ļ‚Ŋ‚étáŠQ—\–h‚Ė•û–@‚Æ‚ĩ‚āCZ“§ˆģ—˜”A–ō‚Ėƒ}ƒ“ƒjƒg[ƒ‹‚⃋[ƒv—˜”A–ō‚ĖƒtƒƒZƒ~ƒh‚ŠŽg—p‚ģ‚ę‚Ä‚Ē‚éB‚ą‚ę‚į‚Ė—˜”A–ō“Š—^‚̓VƒXƒvƒ‰ƒ`ƒ“‚É‚æ‚étáŠQ—\–h‚É—LŒø‚Å‚ ‚é‚Đ‚ðŒŸØ‚·‚éB

‰ð@ā

ƒVƒXƒvƒ‰ƒ`ƒ“‚Ė‘æⅠ ‘ŠŽŽŒą‚É‚Ļ‚Ē‚āC—p—Ę‹K’čˆöŽq‚͐t‹@”\áŠQ‚Å‚ ‚é‚ą‚Æ‚ŠŽĶ‚ģ‚ę‚―1jB•â‰t‚Æ—˜”A–ō‚É‚æ‚č“ŐŦ‚Ė‚ ‚é”’‹ā‘ãŽÓ•Ļ‚ð‘Ž‚â‚Đ‚É”rŸ•‚ĩ”AŨŠĮ‚Æ‚ĖÚGŽžŠÔ‚ð’ቚ‚ģ‚đ‚é‚ą‚ƂŐt‹@”\áŠQ‚ðŒyŒļ‚·‚鎎‚Ý‚Š‚Č‚ģ‚ę‚Ä‚Ŧ‚―B‚ĩ‚Đ‚ĩC–ō•Ļ“Ū‘Ô‰ðÍ‚É‚Ļ‚Ē‚āC—˜”A–ō‚̓VƒXƒvƒ‰ƒ`ƒ““Š—^Œã‚Ė—V—ĢŒ^”’‹ā‚Ė”žŒļŠú‚ɂ͉e‹ŋ‚ð—^‚Ķ‚ļC”A’†”rŸ•—Ķ‚ð’ቚ‚ģ‚đCŒŒī’†‚Ė”’‹ā”Z“x‚ðãļ‚ģ‚đ‚é‚Æ‚ģ‚ę‚Ä‚Ļ‚č2, 3jC—˜”A–ō‚ŠtáŠQ—\–hŒø‰Ę‚ð—L‚·‚é‚Æ‚ĩ‚Ä‚āC‚ŧ‚Ė‹@˜‚͏\•Š‰ð–ū‚ģ‚ę‚Ä‚Ē‚Č‚ĒB

•â‰t‚ƃ}ƒ“ƒjƒg[ƒ‹‚É‚æ‚čt‹@”\áŠQ‚ŠŒyŒļ‚ģ‚ę‚é‚ą‚Æ‚ðÅ‰‚É•ņ‚ĩ‚―‚Ė‚ÍHayes ‚į‚Å‚ ‚éB60 —á‚Ė‚Š‚ņŠģŽŌ‚É‚Ļ‚Ē‚āC•â‰t‚Ļ‚æ‚Ņƒ}ƒ“ƒjƒg[ƒ‹•đ—p‰š‚ō‚—p—Ę‚ĖƒVƒXƒvƒ‰ƒ`ƒ“i120 mg/m2j‚Š“Š—^‚ģ‚ę‚―B‰ðÍ‚ģ‚ę‚―52 —á‚ł́CˆęŽž“I‚ČŒŒīCr ’l‚Ėãļ‚Ė‚݂ŁCd“ĂȐt‹@”\áŠQ‚͐ķ‚ķ‚Č‚Đ‚Á‚―B‚Ų‚Æ‚ņ‚Į‚ĖĮ—á‚ÅŒŒīCr ’l‚Ėãļ‚Í2 mg/dL –Ē–ž‚Å‚ ‚čC10 —á‚Å‚ŧ‚ęˆČã‚Ėãļ‚ð”F‚ß‚―‚ā‚Ė‚ĖC‚ŧ‚Ė‚Ī‚ŋ9 —á‚̓x[ƒX‚ɐt‹@”\’ቚ‚Š‚ ‚čt‹@”\áŠQ‚Ė‚ƒŠƒXƒNŠģŽŌ‚Å‚ ‚Á‚―4jB‚ą‚Ė•ņ‚É‚æ‚čC‚ŧ‚ęˆČŒã‚ĖƒVƒXƒvƒ‰ƒ`ƒ“‚ðŠÜ‚ÞŽĄ—Ö@‚Ė‘å•”•Š‚Ė—Տ°ŽŽŒą‚É‚Ļ‚Ē‚Ä—˜”A–ō‚ŠŽg—p‚ģ‚ę‚é‚ą‚Æ‚Æ‚Č‚Á‚―B

Ostrow ‚į‚̓}ƒ“ƒjƒg[ƒ‹‚ƃtƒƒZƒ~ƒh‚ð”äŠr‚·‚éÅ‰‚ĖŽŽŒą‚ðs‚Á‚―BŠų‘ķ‚ĖŽĄ—ÂɑϐŦ‚Æ‚Č‚Á‚―is‚Š‚ņŠģŽŌ22 —á‚ŠCƒVƒXƒvƒ‰ƒ`ƒ“100 mg/m2‚Ė“Š—^‚É‚Ļ‚Ē‚āCƒ}ƒ“ƒjƒg[ƒ‹37.5 g ‚ð6 ŽžŠÔ‚Đ‚Ŋ‚Ä“_“H‚·‚éŒQ‚ƁC40 mg ‚ĖƒtƒƒZƒ~ƒh‚ðŽĄ—Ã60 •Š‘O‚ɐҍ‚·‚éŒQ‚ÉŠ„‚č•t‚Ŋ‚į‚ęC‚·‚Ũ‚Ä‚ĖĮ—á‚Å“Š—^Œã1 L ‚Ėķ—H‰–…‚Š•â‰t‚ģ‚ę‚―BCcr ‚Š50 mL/•ŠˆČ‰šCŒŒīCr ‚Š2 mg/dL ’ī‚Æ’č‹`‚ģ‚ę‚―t‹@”\áŠQ‚ĖŠ„‡‚́Cƒ}ƒ“ƒjƒg[ƒ‹ŒQ‚Ė22 ‰ņ“Š—^‚Å28“CƒtƒƒZƒ~ƒhŒQ‚Ė25 ‰ņ“Š—^‚Å19“‚Å‚ ‚Á‚―BCcr ‚Ė•―‹Ï’l‚̓}ƒ“ƒjƒg[ƒ‹ŒQCƒtƒƒZƒ~ƒhŒQ‚Å‚ŧ‚ę‚ž‚ę34 mL/•ŠC26 mL/•Š‚Å‚ ‚Á‚―Bƒ}ƒ“ƒjƒg[ƒ‹ŒQ‚Ė‚Ų‚Ī‚É‚æ‚č‹­‚Ēt‹@”\áŠQ‚Š”­Į‚ĩ‚―ŒXŒü‚Š‚ ‚é‚ŠC“ŒvŠw“I‚É‚Í—LˆÓ·‚ð”F‚ß‚Č‚Đ‚Á‚―B‚ĩ‚―‚Š‚Á‚āC‚Į‚ŋ‚į‚Ė—˜”A–ō‚É‚ā—D‰zŦ‚ŠŽĶ‚ģ‚ę‚Č‚Đ‚Á‚―‚ƉðŽß‚ģ‚ę‚Ä‚Ē‚é5jB

Al-Sarraf ‚į‚Í‘O•ûŽ‹“Iƒ‰ƒ“ƒ_ƒ€‰ŧ‘æⅡ‘ŠŽŽŒą‚Æ‚ĩ‚āC•â‰t‚Ė‚Ý‚Æ•â‰t{ƒ}ƒ“ƒjƒg[ƒ‹‚Ė2 ŒQ‚É‚Ļ‚Ŋ‚éƒVƒXƒvƒ‰ƒ`ƒ““Š—^Œã‚Ėt‹@”\áŠQ‚Ė”­Œŧ•p“x‚ð”äŠr‚ĩ‚―B•â‰t‚Ė‚ÝŒQ‚Ė30“‚Ļ‚æ‚Ņ•â‰t{ƒ}ƒ“ƒjƒg[ƒ‹ŒQ‚Ė15“‚ɁC‰‰ņ“Š—^Œã‚Ėt‹@”\áŠQ‚Šķ‚ķ‚―B‘S‘Ė‚Ėt‹@”\áŠQ‚Ė•p“x‚Í39“C32“‚Å‚ ‚Á‚―B‚ĩ‚―‚Š‚Á‚āCƒ}ƒ“ƒjƒg[ƒ‹‚É‚æ‚éƒVƒXƒvƒ‰ƒ`ƒ“‚Ėt‹@”\áŠQ—\–hŒø‰Ę‚͏‰‰ņ“Š—^‚É‚Ļ‚Ē‚Ä‚Ė‚Ý”F‚ß‚į‚ę‚―‚ŠC‚ŧ‚ęˆČ~‚Ė“Š—^‚É‚Ļ‚Ē‚Ä‚Í–ū‚į‚Đ‚Å‚Í‚Č‚Đ‚Á‚―6jB

Santoso ‚į‚Í•â‰tiķ—H‰–…500 mLjC•â‰t{ƒtƒƒZƒ~ƒhi40 mgjC•â‰t{ƒ}ƒ“ƒjƒg[ƒ‹i50 gj‚Ė3 ŒQ‚Ėƒ‰ƒ“ƒ_ƒ€‰ŧ”äŠrŽŽŒą‚É‚æ‚čCƒVƒXƒvƒ‰ƒ`ƒ“‚Ė“Š—^‚É‚æ‚ét‹@”\áŠQ‚Ė—\–hŒø‰Ę‚ð”äŠr‚ĩ‚―B49 —á‚Ė•wl‰Č‚Š‚ņŠģŽŌ‚ɑ΂ĩCƒVƒXƒvƒ‰ƒ`ƒ“75 mg/m2{ƒpƒNƒŠƒ^ƒLƒZƒ‹‚Ü‚―‚Í5-FU ‚ĖŽĄ—Âðs‚ĒCã‹L‚Ė•đ—p—Ö@‚ðƒ‰ƒ“ƒ_ƒ€‚ÉŠ„‚č•t‚Ŋ‚―B15 —á‚Š•â‰t‚Ė‚ÝŒQC17 —á‚Š•â‰t{ƒtƒƒZƒ~ƒhŒQC17 —á‚Š•â‰t{ƒ}ƒ“ƒjƒg[ƒ‹ŒQ‚ÉŠ„‚č‚‚Ŋ‚į‚ęCƒx[ƒXƒ‰ƒCƒ“‚ĖCcr ‚Í3 ŒQ‚Æ‚ā‚Ų‚Ú“Ŋ“™‚Å‚ ‚é‚É‚ā‚Đ‚Đ‚í‚į‚ļCƒVƒXƒvƒ‰ƒ`ƒ“ŽĄ—ÃŒã‚Í•â‰t‚Ė‚ÝŒQC•â‰t{ƒtƒƒZƒ~ƒhŒQC•â‰t{ƒ}ƒ“ƒjƒg[ƒ‹ŒQ‚ĖCcri}•W€•Î·j‚Š80.4i}33.5jC81.4i}23.3jC60.6i}26.8jmL/•Š‚Æ—LˆÓ‚É•â‰t{ƒ}ƒ“ƒjƒg[ƒ‹ŒQ‚Š‘ž‚Ė2 ŒQ‚ɑ΂ĩ‚Ä—ō‚錋‰Ę‚Å‚ ‚Á‚―7jB‚ą‚ĖŽŽŒą‚́C•â‰t{ƒ}ƒ“ƒjƒg[ƒ‹ŒQ‚ĖŽŅ‚ŠˆŦ‚Ē‚ą‚Æ‚Đ‚į’†Ž~‚Æ‚Č‚Á‚Ä‚Ļ‚čCƒTƒ“ƒvƒ‹ƒTƒCƒY‚ŠŽ‚ģ‚Ē‚ą‚ƁCƒ}ƒ“ƒjƒg[ƒ‹‚Ė—Ę‚ŠˆČ‘O‚ĖŽŽŒą‚æ‚č‚ā‘―‚Ē‚ą‚ƁCCcr ‚Ė’~”A‚ŠŒĩ–§‚ɍs‚í‚ę‚Ä‚Ē‚Č‚Ē‚ą‚Æ‚Č‚Į‚ŠŽw“E‚ģ‚ę‚Ä‚Ļ‚čCƒ‰ƒ“ƒ_ƒ€‰ŧ”äŠrŽŽŒą‚Å‚Í‚ ‚é‚ā‚Ė‚ĖŽŋ‚Ė‚‚ĒŽŽŒą‚Æ‚Í‚Ē‚Ē‚Š‚―‚ĒB

‚ĩ‚―‚Š‚Á‚āC”’‹āŧÜ‚É‹Nˆö‚·‚étáŠQ—\–h‚Ė–Ú“I‚ŁC1970 ”N‘ã‚ÉŠJŽn‚ģ‚ęL‚­s‚í‚ę‚Ä‚Ē‚é—˜”A–ō“Š—^‚ɂ́C–ūŠm‚É‚ŧ‚Ė—LŒøŦ‚ðŽĶ‚·ƒ‰ƒ“ƒ_ƒ€‰ŧ”äŠrŽŽŒą‚Š‚Č‚­C„§‚·‚é‚ū‚Ŋ‚ĖŠ‹’‚Š‚Č‚Ē‚Ė‚ŠŒŧó‚Å‚ ‚éBEuropean Society of Clinical Pharmacy Special Interest GroupiESCP SIGj‚É‚æ‚éƒVƒXƒvƒ‰ƒ`ƒ“‚É‹Nˆö‚·‚étáŠQ—\–h‚Ė‚―‚ß‚Ė„§•ķ‚É‚Ļ‚Ē‚ẮC—˜”A–ō‚Ė“Š—^‚𐄏§‚·‚闝—R‚Š‚Č‚Ē‚Æ‚ĩ‚Ä‚Ē‚é8jB‚―‚ū‚ĩCƒVƒXƒvƒ‰ƒ`ƒ““Š—^‚É‚Ļ‚Ŋ‚é—˜”A–ō‚ĖŽg—p‚Í’·”N‚É‚í‚―‚čL‚­s‚í‚ę‚Ä‚Ļ‚čC‚ą‚Ė•û–@‚ð—p‚Ē‚Ä‚ģ‚Ü‚ī‚Ü‚ČŽĄ—Ö@‚ĖƒGƒrƒfƒ“ƒX‚Š‘no‚ģ‚ę‚Ä‚Ē‚é‚―‚߁CˆĀ‘SŦ‚ÍŠm—§‚ĩ‚Ä‚Ē‚éB‹ß”NŽŽ‚ģ‚ę‚Ä‚Ē‚éshort hydration –@‚É‚Ļ‚Ē‚Ä‚āC—˜”A–ōŽg—p‚ð‘O’ņ‚Æ‚ĩ‚āC‚ŧ‚ĖˆĀ‘SŦ‚Š•ņ‚ģ‚ę‚Ä‚Ē‚éB‚ĩ‚―‚Š‚Á‚āC—˜”A–ō‚É‚æ‚č–ū‚į‚Đ‚Č•s—˜‰v‚ŠØ–ū‚ģ‚ę‚Č‚ĒŒĀ‚č‚́C„§‚ĩ‚Č‚ĒŠ‹’‚ā–R‚ĩ‚ĒB

yŽQl•ķŒĢz

1j Higby DJ, et al. DiaminodichloroplatinumFa phase‡T study showing responses in testicular and other tumors. Cancer. 1974G33F1219-5. PMIDF4856724

2j Dumas M, et al. Evaluation of the effect of furosemide on ultrafilterable platinum kinetics in patients treated with cis-diamminedichloroplatinum. Cancer Chemother Pharmacol. 1989G23F37-40. PMIDF2909288

3j Belt RJ, et al. Pharmacokinetics of non-protein-bound platinum species following administration of cis-dichlorodiammineplatinumiⅡj. Cancer Treat Rep. 1979G63F1515-21. PMIDF498151

4j Hayes DM, et al. High dose cis-platinum diammine dichlorideFamelioration of renal toxicity by mannitol diuresis. Cancer. 1977G39F1372-81. PMIDF856437

5j Ostrow S, et al. High-dose cisplatin therapy using mannitol versus furosemide diuresisFcomparative pharmacokinetics and toxicity. Cancer Treat Rep. 1981G65F73-8. PMIDF6784924

6j Al-Sarraf M, et al. Cisplatin hydration with and without mannitol diuresis in refractory disseminated malignant melanomaFa southwest oncology group study. Cancer Treat Rep. 1982G66F31-5. PMIDF6796269

7j Santoso JT, et al. Saline, mannitol, and furosemide hydration in acute cisplatin nephrotoxicityFa randomized trial. Cancer Chemother Pharmacol. 2003G52F13-8. PMIDF12719883

8j Launay-Vacher V, et al.Gfor the European Society of Clinical Pharmacy Special Interest Group on Cancer Care. Prevention of cisplatin nephrotoxicityFstate of the art and recommendations from the European Society of Clinical Pharmacy Special Interest Group on Cancer Care. Cancer Chemother Pharmacol. 2008G61F903-9. PMIDF18317762


CQ9

ƒ}ƒOƒlƒVƒEƒ€“Š—^‚̓VƒXƒvƒ‰ƒ`ƒ“‚É‚æ‚étáŠQ‚Ė—\–h‚ɐ„§‚ģ‚ę‚é‚ЁH

ƒ}ƒOƒlƒVƒEƒ€“Š—^‚É‚æ‚čC’áƒ}ƒOƒlƒVƒEƒ€ŒŒĮ—\–hŒø‰Ę‚ÍŠú‘Ō‚Å‚Ŧ‚éB‚Ü‚―t‹@”\‚Ö‚ĖD‰e‹ŋ‚āŽĶī‚ģ‚ę‚Ä‚Ļ‚čCtáŠQ‚Ė—\–h‚Ė‚―‚߂Ƀ}ƒOƒlƒVƒEƒ€“Š—^‚͐„§‚ģ‚ę‚éB

„§ƒOƒŒ[ƒh
s‚Ī‚ą‚Æ‚ðŽã‚­„§‚·‚éi’ņˆÄ‚·‚éj
—v@–ņ

ƒ}ƒOƒlƒVƒEƒ€—\–h“Š—^‚É‚æ‚čƒVƒXƒvƒ‰ƒ`ƒ““Š—^Œã‚Ė’áƒ}ƒOƒlƒVƒEƒ€ŒŒĮ‚ð—\–h‚ĩtáŠQ‚ĖŒyŒļ‚ŠŠú‘Ō‚Å‚Ŧ‚éB

”wŒiE–Ú“I

ƒVƒXƒvƒ‰ƒ`ƒ““Š—^Žž‚ɂ́C‚Ļ‚ā‚ɐt‚Đ‚į‚Ė”rŸ•˜īi‚ƏÁ‰ŧŠĮ“ŐŦ‚É‚æ‚čC’áƒ}ƒOƒlƒVƒEƒ€ŒŒĮ‚Š‚•p“x‚É”­Œŧ‚·‚éB’áƒ}ƒOƒlƒVƒEƒ€ŒŒĮ‚ŠtáŠQ‚ðˆø‚Ŧ‹N‚ą‚·‰Â”\Ŧ‚ā•ņ‚ģ‚ę‚Ä‚Ļ‚čCƒ}ƒOƒlƒVƒEƒ€‚Ė—\–h“Š—^‚É‚æ‚čtáŠQ‚ĖŒyŒļ‚ŠŠú‘Ō‚ģ‚ę‚Ä‚Ē‚éB

‰ð@ā

‚—p—ĘƒVƒXƒvƒ‰ƒ`ƒ“‚ð“Š—^‚ĩ‚―ŠģŽŌ‚É‚Ļ‚Ē‚ă}ƒOƒlƒVƒEƒ€“Š—^‚Æ”ņ“Š—^‚ŐtáŠQ‚ð”äŠr‚ĩ‚―ŒĪ‹†‚́C‚ą‚ę‚܂łɃ‰ƒ“ƒ_ƒ€‰ŧ”äŠrŽŽŒą‚Š2 Œ‚ƃŒƒgƒƒXƒyƒNƒeƒBƒu‚ȉðÍ‚Š1 Œ‚ ‚é1-3jB

Willox ‚į‚́C16 —á‚Ėļ‘ƒŽîᇂĻ‚æ‚Ņ1 —á‚Ė—‘‘ƒŽîᇂŃVƒXƒvƒ‰ƒ`ƒ““Š—^‚·‚é—\’č‚ĖŠģŽŌ‚ðƒ}ƒOƒlƒVƒEƒ€“Š—^‚·‚éŒQ‚ƃ}ƒOƒlƒVƒEƒ€”ņ“Š—^ŒQ‚Ƀ‰ƒ“ƒ_ƒ€‰ŧ‚ĩŽĄ—Âðs‚Á‚―‚Æ‚ą‚ëCƒ}ƒOƒlƒVƒEƒ€”ņ“Š—^ŒQ‚Å‚ÍŽ…‹…‘ĖáŠQiNAG ‚’lj‚Š—LˆÓ‚É‚Ý‚į‚ę‚―‚ą‚Æ‚ð•ņ‚ĩ‚Ä‚Ē‚é1jB‚Ü‚―Bodnar ‚į‚́CƒVƒXƒvƒ‰ƒ`ƒ““Š—^—\’č‚Ė—‘‘ƒŽîᇊģŽŌ‚ð“ņd–ÓŒŸ‚ɂă}ƒOƒlƒVƒEƒ€“Š—^ŒQ‚ƃ}ƒOƒlƒVƒEƒ€”ņ“Š—^iƒvƒ‰ƒZƒ{jŒQ‚Ƀ‰ƒ“ƒ_ƒ€‰ŧ‚ĩ‚Ä”äŠr‚ĩCƒ}ƒOƒlƒVƒEƒ€“Š—^ŒQ‚̓vƒ‰ƒZƒ{ŒQ‚Æ”äŠr‚ĩ—LˆÓ‚ÉGFR ‚Š—ĮD‚Å‚ ‚Á‚―‚ą‚Æ‚ð•ņ‚ĩ‚Ä‚Ē‚é2jB‚Į‚ŋ‚į‚ĖŒĪ‹†‚āCƒ}ƒOƒlƒVƒEƒ€—\–h“Š—^‚É‚æ‚čt‹@”\‚֍D‰e‹ŋ‚ŠŽw“E‚ģ‚ę‚Ä‚Ē‚é‚ŠCŽ‹K–Í‚ČƒTƒ“ƒvƒ‹ƒTƒCƒY‚ŃGƒ“ƒhƒ|ƒCƒ“ƒg‚ⓝŒvŠw“I‚ȉžā‚Š•s–ūŠm‚Å‚ ‚éB‚ĩ‚―‚Š‚Á‚Đt‹@”\áŠQ‚Ė—\–hŒø‰Ę‚ÍŠú‘Ō‚Å‚Ŧ‚é‚ŠC–ūŠm‚ÉŒŸØ‚ģ‚ę‚―‚Æ‚Í‚Ē‚Ķ‚Č‚ĒB

‚ĩ‚Đ‚ĩ‚Č‚Š‚įƒ}ƒOƒlƒVƒEƒ€—\–h“Š—^‚É‚æ‚č’áƒ}ƒOƒlƒVƒEƒ€ŒŒĮ—\–hė—p‚Šķ‚ķC‚ŧ‚ę‚É”š‚ĒtáŠQ‚ðŠÜ‚ß‚―—LŠQ”―‰ž‚ðŒyŒļ‚Å‚Ŧ‚é‚ą‚Ƃ͐„Ž@‚ģ‚ęCƒ}ƒOƒlƒVƒEƒ€—\–h“Š—^‚É‚æ‚é—LŠQ”―‰ž‚āŒy”ũ‚Å‚ ‚é‚ą‚Æ‚ðl—ķ‚·‚é‚ƁCŒŧŽž“_‚Ń}ƒOƒlƒVƒEƒ€—\–h“Š—^‚͐„§‚ģ‚ę‚éB

yŽQl•ķŒĢz

1j Willox JC, et al. Effects of magnesium supplementation in testicular cancer patients receiving cis-platinFa randomised trial. Br J Cancer. 1986G54F19-23. PMIDF3524645

2j Bodnar L, et al. Renal protection with magnesium subcarbonate and magnesium sulphate in patients with epithelial ovarian cancer after cisplatin and paclitaxel chemotherapyFa randomised phase Ⅱ study. Eur J Cancer. 2008G44F2608-14. PMIDF18796350

3j Yoshida T, et al. Protective effect of magnesium preloading on cisplatin-induced nephrotoxicityFa retrospective study. Jpn J Clin Oncol. 2014G44F346-54. PMIDF24503028


CQ10

t‹@”\‚ÉŠî‚­ƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ““Š—^—ʐݒč‚͐„§‚ģ‚ę‚é‚ЁH

ƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚ð“Š—^‚ģ‚ę‚鐎l‚Š‚ņŠģŽŌ‚É‚Ļ‚Ē‚āC–Ú•W‚Æ‚·‚éAUC ‚ðÝ’č‚ĩ‚―‚Ī‚Ķ‚Őt‹@”\‚ÉŠî‚ÂĒ‚Ä“Š—^—Ę‚ðŒˆ’č‚·‚é•û–@‚́C‘Ė•\–ĘÏ‚ÉŠî‚­ˆę”Ę“I‚Č•û–@‚Æ”äŠr‚ĩ‚ÄŽĄ—ÃŒø‰Ę‚ð‚‚ß‚Đ‚Â•›ė—p‚ðŒyŒļ‚ģ‚đ‚é‚Æ‚Ē‚ĪƒGƒrƒfƒ“ƒX‚͏\•Š‚Å‚Í‚Č‚ĒB‚ĩ‚Đ‚ĩC‚ą‚Ėt‹@”\‚ÉŠî‚­“Š—^—ʐݒč–@‚͍‡—“I‚Å‚ ‚čC‚Ђ“úí—Տ°‚ł͍L‚­•‹y‚ĩ‚Ä‚Ē‚éB

„§ƒOƒŒ[ƒh
s‚Ī‚ą‚Æ‚ð‹­‚­„§‚·‚é
—v@–ņ

ƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚ð“Š—^‚ģ‚ę‚鐎l‚Š‚ņŠģŽŌ‚É‚Ļ‚Ē‚āC–Ú•W‚Æ‚·‚éAUC ‚ðÝ’č‚ĩ‚―‚Ī‚Ķ‚Őt‹@”\‚ÉŠî‚ÂĒ‚Ä“Š—^—Ę‚ðŒˆ’č‚·‚é•û–@‚́C‘Ė•\–ĘÏ‚ÉŠî‚­ˆę”Ę“I‚Č•û–@‚Æ”äŠr‚ĩ‚ÄŽĄ—ÃŒø‰Ę‚ð‚‚ß‚Đ‚Â•›ė—p‚ðŒyŒļ‚ģ‚đ‚é‚Æ‚Ē‚ĪƒGƒrƒfƒ“ƒX‚͏\•Š‚Å‚Í‚Č‚ĒB‚ĩ‚Đ‚ĩC‚ą‚Ėt‹@”\‚ÉŠî‚­“Š—^—ʐݒč–@‚͍‡—“I‚Å‚ ‚čC‚Ђ“úí—Տ°‚ł͍L‚­•‹y‚ĩ‚Ä‚Ē‚é‚ą‚Æ‚Đ‚įC„§‚Ė‹­‚ģ‚́u‹­‚Ēv‚Æ‚ĩ‚―B

”wŒiE–Ú“I

”’‹āŧÜ‚Å‚ ‚éƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚Í‘Ė“ā“Š—^Œã‚É‚ŧ‚Ė‚Ų‚Æ‚ņ‚Į‚Št‚Đ‚į”rŸ•‚ģ‚ę‚é‚―‚߁CGFR ‚ÉŠî‚ÂĒ‚Ä‘Ė“ā–ō•Ļ“Ū‘Ô‚ð—\‘Š‚Å‚Ŧ‚éB‚ģ‚į‚ɁC‘Ė“ā–ō•Ļ”˜˜I—Ę‚ĖŽw•W‚Å‚ ‚éAUC ‚ÆŒŒ‰t“ŐŦ‚Ļ‚æ‚ŅRŽîᇌø‰Ę‚Í‚æ‚­‘ŠŠÖ‚·‚éB‚ŧ‚Ė‚―‚߁C–Ú•W‚Æ‚·‚éAUC ‚ðÝ’č‚ĩ‚―‚Ī‚Ķ‚ÅGFR ‚ÉŠî‚ÂĒ‚Ä“Š—^—Ę‚ðŒˆ’č‚·‚é•û–@‚ŠL‚­•‹y‚ĩ‚Ä‚Ē‚éBGFR ‚ÍCcr ‚Å‘ã—p‚·‚é‚ą‚Æ‚Š‘―‚ĒB–{e‚ł́C“úí—Տ°‚Å—p‚Ē‚į‚ę‚Ä‚Ē‚éCt‹@”\‚ÉŠî‚­ƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚Ė“Š—^—ʐݒ肊‘Ó–‚Å‚ ‚é‚Ђɂ‚Ē‚ÄŒŸ“Ē‚ĩ‚―B

‰ð@ā

ƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚Í•wl‰Č‚Š‚ņ‚â”x‚Š‚ņ‚ð‚Í‚ķ‚ß‚Æ‚·‚镝L‚ĒRŽîᇃXƒyƒNƒgƒ‹‚ð—L‚·‚é”’‹āŧÜ‚Å‚ ‚éB‘Ė“ā‚É“Š—^‚ģ‚ę‚―ƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚Ė‚Ų‚Æ‚ņ‚Į‚͐t‚Đ‚į”rŸ•‚ģ‚ę‚é‚―‚߁CGFR ‚ÉŠî‚ÂĒ‚Ä‘Ė“ā–ō•Ļ“Ū‘Ô‚ð—\‘Š‚Å‚Ŧ‚é1jB‚ģ‚į‚ɁC‘Ė“ā–ō•Ļ”˜˜I—Ę‚ĖŽw•W‚Å‚ ‚éAUC ‚ƃJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚Ė—p—ʐ§ŒĀ“ŐŦ‚Å‚ ‚錌‰t“ŐŦC‚Æ‚­‚ÉŒŒŽ”ÂŒļ­C‚Ļ‚æ‚ŅRŽîᇌø‰Ę‚Ė‘ŠŠÖ‚Í‹­‚ĒB‚ĩ‚―‚Š‚Á‚āCƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚É‚æ‚é•›ė—p‚Ļ‚æ‚ŅŒø‰Ę‚ĖŒÂ‘ĖŠÔ·‚́CŽĄ—ÑO‚ĖGFR‚É‹Nˆö‚·‚éAUC‚ĖŒÂ‘ĖŠÔ·‚É‚æ‚Á‚Đā–ū‚Å‚Ŧ‚é2jB–Ú•W‚Æ‚·‚éAUC ‚ðÝ’č‚ĩ‚―‚Ī‚Ķ‚ÅGFR ‚ÉŠî‚ÂĒ‚Ä“Š—^—Ę‚ðŒˆ’č‚·‚ę‚΁CAUC ‚ĖŒÂ‘ĖŠÔ·‚͍ŏŽŒĀ‚Æ‚Č‚čC‚ŧ‚ĖŒ‹‰Ę‚Æ‚ĩ‚ďd“Ä‚ČŒŒ‰t“ŐŦ‚â‰ß­ŽĄ—ÂĖŠëŒŊŦ‚ð’áŒļ‚ģ‚đ‚é‚ą‚Æ‚ŠŠú‘Ō‚Å‚Ŧ‚éB‚ą‚Ė‚æ‚Ī‚ȍl‚Ķ‚Đ‚įCCalvert ‚į‚ÍGFR ‚ÉŠî‚ÂĒ‚ăJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚Ė“Š—^—Ę‚ðŒˆ’č‚·‚éŒvŽZŽŪiCalvert ŽŪj‚ðėŽ‚ĩC‚ŧ‚ę‚͍Ą“ú‚Ü‚Å“úí—Տ°‚ōL‚­—p‚Ē‚į‚ę‚Ä‚Ē‚é3jB

Calvert ŽŪF“Š—^—ʁmmgn–Ú•WAUCmmg/mL~•Šn~iGFRmmL/•Šn{25j

“Š—^—Ę‚ĖŒvŽZ‚ɂ́C‚ ‚į‚Đ‚ķ‚ߐݒč‚ģ‚ę‚―–Ú•WAUC ‚ÆŠģŽŌ‚ĖGFR ’l‚ðCalvert ŽŪ‚É‘ã“ü‚·‚éB—Տ°ŽŽŒą‚ÉŠî‚ÂĒ‚ÄAUC ‚Í5`7 ‚ɐݒč‚ģ‚ę‚é‚ŠC—‘‘ƒ‚Š‚ņŠģŽŌ‚ð‘ΏۂƂĩ‚―ƒ‚ƒfƒ‹‰ðÍ‚É‚æ‚é‚ƁCƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚ĖRŽîᇌø‰Ę‚ÍAUC 5`7 ‚Å‚Ų‚Ú“Š‘Å‚ŋ‚Æ‚Č‚é‚ŠCŒŒŽ”ÂŒļ­‚Č‚ĮŒŒ‰t“ŐŦ‚ÍAUC ‚Ė‘‰Á‚Æ‚Æ‚ā‚É‚ģ‚į‚É‘‹­‚·‚é‚ą‚Æ‚ŠŽĶ‚ģ‚ę‚Ä‚Ē‚é4jB‚ŧ‚Ė‚Ų‚ЁCEgorin ‚į5, 6jCChatelut ‚į7j‚ā“Ŋ—l‚ɐt‹@”\‚ÉŠî‚­ƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚Ė“Š—^—ĘŒvŽZŽŪ‚ðėŽ‚ĩ‚Ä‚Ē‚é‚ŠCŒvŽZ‚ŠŠČ•Ö‚Å‚ ‚é‚ą‚Æ‚Đ‚įŒŧÝ‚Å‚ÍCalvert ŽŪ‚Š—p‚Ē‚į‚ę‚Ä‚Ē‚éB‚Ē‚ļ‚ę‚É‚đ‚æC‚ą‚Ė‚æ‚Ī‚ɐt‹@”\‚ÉŠî‚ÂĒ‚Ä“Š—^—Ę‚ðŒˆ’č‚·‚é•û–@‚͍‡—“I‚Å‚ ‚é‚ŠC‘Ė•\–ĘÏ‚ÉŠî‚­ˆę”Ę“I‚Č•û–@‚Æ”äŠr‚ĩ‚ÄŽĄ—ÃŒø‰Ę‚ð‚‚ß‚Đ‚Â•›ė—p‚ðŒyŒļ‚ģ‚đ‚é‚Æ‚Ē‚ĪŠÏ“_‚Å‘OŒü‚Ŧ‚ÉŒŸØ‚ĩ‚―—Տ°ŽŽŒą‚Í‘ķÝ‚đ‚ļC‚ŧ‚ĖƒGƒrƒfƒ“ƒX‚͏\•Š‚Å‚Í‚Č‚ĒB

‚Ü‚―CCalvert ŽŪ‚ĖėŽ‰ß’ö‚ł̓Nƒƒ€‚Ė•úŽËŦ“ŊˆĘŒģ‘f51Cr ‚Å•WŽŊ‚ĩ‚―EDTA ‚ĖƒNƒŠƒAƒ‰ƒ“ƒX‘Š’č‚É‚æ‚éŽĀ‘ŠGFR ‚Š—p‚Ē‚į‚ę‚―B“ú–{‚Å‚ÍGFR ‚Ėgold standard ‚Å‚ ‚éƒCƒkƒŠƒ“EƒNƒŠƒAƒ‰ƒ“ƒX‚Š•ÛŒŊf—ÂƂĩ‚Ä‘Š’č‚Å‚Ŧ‚é‚ŠC‚ŧ‚ĖŽč‡‚Š”ÏŽG‚Å‚ ‚é‚ą‚Æ‚Đ‚į“úí—Տ°‚Å‚ÍCcr ‚Å‘ã—p‚·‚é‚ą‚Æ‚Š‘―‚ĒB‚ĩ‚Đ‚ĩCŒŒī’†‚É‘ķÝ‚·‚éCr ‚ÍŽ…‹…‘Ėāh‰ß‚ɉÁ‚Ķ‚Ä”AŨŠĮ‚Đ‚į‚ā–ņ20`30“‚Š•Š”å‚ģ‚ę‚é‚―‚߁C‚ŧ‚Ė•Š‚ū‚ŊCcr ‚ÍGFR ‚æ‚č‚’l‚Æ‚Č‚é“_‚É’ˆÓ‚Š•K—v‚Å‚ ‚éBCcr ‚ĖŒvŽZ‚É—p‚Ē‚į‚ę‚錌īCr ’l‚Ė‘Š’č‚ɂ́CJaffé –@‚ƍy‘f–@‚Š—p‚Ē‚į‚ę‚éBJaffé –@‚Ėę‡CŒŒī’†‚Ė”ņ“ÁˆŲ“I•ĻŽŋ‚Ė‰e‹ŋ‚ðŽó‚Ŋ‚é‚―‚߁CŒŒīCr ‘Š’č’l‚͐^’l‚æ‚č–ņ0.2 mg/dL ‚’l‚Æ‚Č‚éB‚ĩ‚Đ‚ĩCCcr ‚ĖŒvŽZ‚É‚Ļ‚Ē‚ẮC‚ą‚Ė‘Š’č’l‚ĖŒë·‚Æ”AŨŠĮ•Š”å‚É‚æ‚éGFR ‚Æ‚Ė·‚Í‘ŠŽE‚ģ‚ę‚é‚ą‚Æ‚É‚Č‚čCŒ‹‰Ę“I‚ÉJaffé –@‚Å‘Š’č‚ģ‚ę‚―ŒŒīCr ‚ð—p‚Ē‚―Ccr ‚ÍGFR ‚É‚Ų‚ڋߎ—‚·‚éBˆę•ûCy‘f–@‚Ėę‡CŒŒīCr ‘Š’č’l‚͐ģŠm‚Å‚ ‚čCCcr ‚ÍGFR ‚æ‚č‚’l‚Æ‚Č‚éB‚ĩ‚―‚Š‚Á‚āCCcr ‚ðGFR ‚Ė‘ã—p‚Æ‚ĩ‚ÄCalvert ŽŪ‚É—p‚Ē‚é‚ƃJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚Ė‰ßč“Š—^‚Æ‚Č‚éŠëŒŊŦ‚Š‚ ‚éB“ú–{‚Å‚Í1990 ”N‘㔞‚ÎˆČ~‚Ų‚Æ‚ņ‚Į‚Ėˆã—ÃŽ{Ý‚É‚Ļ‚Ē‚čy‘f–@‚ŠŽg—p‚ģ‚ę‚Ä‚Ē‚é‚ŠC‰Ē•Ä‚ł͍ŋ߂܂ÅJaffé –@‚Š—p‚Ē‚į‚ę‚Ä‚Ŧ‚―BŠCŠO‚ōs‚í‚ę‚―ƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚Ė—Տ°ŽŽŒą‚Ė‰ðŽß‚É‚Í’ˆÓ‚Š•K—v‚Å‚ ‚éB‚ŧ‚Ė‘΍ô‚Æ‚ĩ‚āCCcr ‚ĖŒvŽZ‚É‚Ļ‚Ē‚āCy‘f–@‚É‚æ‚錌īCr ‘Š’č’l‚É0.2 ‚ð‰Á‚Ķ‚é•û–@‚Š’ņĨ‚ģ‚ę‚Ä‚Ē‚é8, 9jBGFR ‚ðŽg—p‚·‚éę‡C“ú–{t‘ŸŠw‰ï‚É‚æ‚Á‚čėŽ‚ģ‚ę‚―CGFR „ŽZŽŪieGFRj‚Đ‚į‘Ė•\–ĘÏ•âģ‚ð‚ĩ‚Č‚ĒGFR ‚ðŒvŽZ‚ĩ‚Ä—p‚Ē‚éiCQ1 ŽQÆjBˆę•ûCŒŧÝ‚ā“ú–{‚Ė—Տ°ŽŽŒą‚Ė‘―‚­‚͍y‘f–@‚Å‘Š’č‚ĩ‚―ŒŒīCr ’l‚Đ‚į„ŽZ‚ĩ‚―Ccr ‚ð‚ŧ‚Ė‚Ü‚ÜGFR ‚Æ‚ĩ‚Ä—p‚Ē‚Ä‚Ē‚éB‚ą‚ę‚į‚ĖŽŽŒą‚ĖƒGƒrƒfƒ“ƒX‚ð—Տ°‚Å—p‚Ē‚éę‡CŽĀÛ‚ĖAUC ‚ƐݒčAUC ‚Æ‚Ė‚ ‚Ē‚ū‚É–ū‚į‚Đ‚ČƒoƒCƒAƒX‚Š‘ķÝ‚ĩ‚Ä‚Ē‚Ä‚āC‚ŧ‚ę‚ž‚ę‚ĖŽŽŒą‚Æ“Ŋ‚ķ•û–@‚Ő„ŽZ‚ģ‚ę‚―GFR ‚ð—p‚Ē‚é‚ą‚Æ‚É‚Č‚éB‚ĩ‚Đ‚ĩCt‹@”\‚ÉŠî‚­“Š—^—ĘŒÂ•Ę‰ŧ‚Ė–Ú“I‚ðl‚Ķ‚ę‚΁CŽĀÛ‚ĖAUC ‚ƐݒčAUC ‚ĖƒoƒCƒAƒX‚Š‚Č‚Ē‚æ‚Ī‚ɁC—Տ°ŽŽŒą‚Ė’iŠK‚Đ‚įģŠm‚É•]‰ŋ‚ģ‚ę‚―t‹@”\‚ð—p‚Ē‚é‚Ė‚Š“KØ‚Å‚ ‚éB

•Ä‘‚ł́CŒŒīCr ‘Š’č–@‚Í2010 ”N‚܂łɍy‘f–@‚Æ“Ŋ—l‚ɐģŠm‚Č“ŊˆĘ‘ĖŠóŽßŽŋ—Ę•ŠÍ–@iIDMS –@j‚Ɉڍs‚ĩ‚―B‚ŧ‚ę‚É”š‚Á‚āCt‹@”\‚Ė‰ß‘å•]‰ŋ‚É‚æ‚éƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚Ė‰ß—Ę“Š—^‚ð‰ņ”ð‚·‚é‚―‚ß‚ÉCalvert ŽŪ‚É—p‚Ē‚éGFR ‚ĖãŒĀ’li125 mL/•Šj‚ðÝ‚Ŋ‚é‚ą‚Æ‚Š„§‚ģ‚ę‚Ä‚Ē‚éB•wl‰Č—Ėˆæ‚ł́C‹É’[‚É’á‚ĒŒŒīCr ’l‚ɉšŒĀ’li0.7 mg/dLj‚ðÝ‚Ŋ‚é‚ą‚Æ‚ās‚í‚ę‚Ä‚Ē‚éB‚ą‚ę‚į‚Ė•û–@‚ł́CŽĀÛ‚ĖAUC ‚͑唞‚ĖŠģŽŌ‚ŐݒčAUC ‚æ‚č‘å‚Ŧ‚­C‚Ü‚―t‹@”\‚Ė—Į‚Ēˆę•”‚ĖŠģŽŌ‚ł͐ݒčAUC ‚æ‚菮‚ģ‚­‚Č‚Á‚Ä‚Ē‚é“_‚É’ˆÓ‚Š•K—v‚Å‚ ‚éB

Calvert ŽŪ‚ĖgGFR{25h‚̓Jƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚Ė‘ƒNƒŠƒAƒ‰ƒ“ƒX‚É‘Š“–‚ĩ‚Ä‚Ļ‚čC‚ŧ‚Ė‚Ī‚ŋgGFRh‚͐tƒNƒŠƒAƒ‰ƒ“ƒXC’萔g25h‚Í”ņtƒNƒŠƒAƒ‰ƒ“ƒX‚É‘Š“–‚·‚éB”ņtƒNƒŠƒAƒ‰ƒ“ƒX‚Í‚Ļ‚ā‚É‘ĖŠi‚Ė‘å‚Ŧ‚ģ‚Ɉˑķ‚·‚éBCalvert ŽŪ‚͉p‘‚ōėŽ‚ģ‚ę‚Ä‚Ļ‚čC”’l‚Æ”äŠr‚ĩ‚Ä•―‹Ï“I‚Č‘ĖŠi‚ŠŽ‚ģ‚Ē“ú–{l‚ɑ΂ĩ‚ÄCalvert ŽŪ‚ð—p‚Ē‚éę‡C‚Æ‚­‚ɏd“x‚Ėt‹@”\’ቚ—á‚Å‚ÍGFR ‚Æ”äŠr‚ĩ‚Ä‘Š‘ΓI‚É”ņtƒNƒŠƒAƒ‰ƒ“ƒX‚ĖŠ„‡‚Š‚‚­‚Č‚é‚―‚߁CƒJƒ‹ƒ{ƒvƒ‰ƒ`ƒ“‚Š‰ß—Ę“Š—^‚É‚Č‚é‰Â”\Ŧ‚Š‚ ‚é10jB

Ccr ‚Ė‘Š’č‚É‚Í’~”Ai’ʏí‚Í24 ŽžŠÔj‚Š•K—v‚Å‚ ‚é‚ŠCŒŒīCr ’l‚Đ‚įŒvŽZ‚ģ‚ę‚鐄ŽZ’l‚ðGFR ‚Ė‘ã—p‚Æ‚ĩ‚Ä—p‚Ē‚é‚ą‚Æ‚Š‚ ‚éBCcr ‚Ė„ŽZŽŪ‚É‚ÍCockcroft-Gault ŽŪ‚âJelliffe ŽŪCGFR ‚Ė„ŽZŽŪ‚ɂ͉Ē•Ä‚ĖMDRD ŽŪCCKD-EPI ŽŪCWright ŽŪC‘Oq‚ĩ‚―“ú–{l‚ĖGFR „ŽZŽŪieGFRj‚Š‚ ‚éiCQ1 ŽQÆjB‚ą‚ę‚į‚Ė„ŽZŽŪ‚ð—p‚Ē‚éę‡‚ɂ͐lŽí·‚â•a‘Ô‚Č‚ĮŠģŽŌ”wŒiCŒŒīCr ‘Š’č–@‚É’ˆÓ‚ĩ‚Č‚Ŋ‚ę‚΂Ȃį‚Č‚ĒB‚Ü‚―C„ŽZŽŪ‚ĖŽg—p‚ÍŒŒīCr ‚ŠˆĀ’č‚ĩ‚Ä‚Ē‚é‚ą‚Æ‚Š‘O’ņ‚Å‚ ‚čCt•s‘S‚Ė‹}ŦŠú‚Č‚Įt‹@”\‚Ė•Ï“Ū‚Š‘å‚Ŧ‚Ē‚Æ‚Ŧ‚âCƒTƒ‹ƒRƒyƒjƒA‚â’á‰h—{ó‘Ô‚Č‚Į‹É’[‚É‹Ø“ũ—Ę‚ŠŒļ‚Á‚―ó‘Ԃł͐t‹@”\‚Š‰ß‘å•]‰ŋ‚ģ‚ę‚éB

yŽQl•ķŒĢz

1j Calvert AH, et al. Phase‡T studies with carboplatin at the Royal Marsden Hospital. Cancer Treat Rev. 1985G12 Suppl AF51-7. PMIDF3910222

2j Harland SJ, et al. Pharmacokinetics of cis-diammine-1,1-cyclobutane dicarboxylate platinumiⅡjin patients with normal and impaired renal function. Cancer Res. 1984G44F1693-7. PMIDF6367971

3j Calvert AH, et al. Carboplatin dosageFprospective evaluation of a simple formula based on renal function. J Clin Oncol. 1989G7F1748-56. PMIDF2681557

4j Jodrell DI, et al. Relationships between carboplatin exposure and tumor response and toxicity in patients with ovarian cancer. J Clin Oncol. 1992G10F520-8. PMIDF1548516

5j Egorin MJ, et al. Pharmacokinetics and dosage reduction of cis-diamminei1,1-cyclobutanedicarboxylatojplatinum in patients with impaired renal function. Cancer Res. 1984G44F5432-8. PMIDF6386150

6j Egorin MJ, et al. Prospective validation of a pharmacologically based dosing scheme for the cis-diamminedichloroplatinumiⅡjanalogue diamminecyclobutanedicarboxylatoplatinum. Cancer Res. 1985G45F6502-6. PMIDF3904984

7j Chatelut E, et al. Prediction of carboplatin clearance from standard morphological and biological patient characteristics. J Natl Cancer Inst. 1995G87F573-80. PMIDF7752255

8j Ando Y, et al. Adjustment of creatinine clearance improves accuracy of Calvertfs formula for carboplatin dosing. Br J Cancer. 1997G76F1067-71. PMIDF9376268

9j Ando M, et al. Multi-institutional validation study of carboplatin dosing formula using adjusted serum creatinine level. Clin Cancer Res. 2000G6F4733-8. PMIDF11156227

10j Shimokata T, et al. Prospective evaluation of pharmacokinetically guided dosing of carboplatin in Japanese patients with cancer. Cancer Sci. 2010G101F2601-5. PMIDF20860621


i3j‚ŧ‚Ė‘ž‚Ė–ōÜ

CQ11

‘å—ĘƒƒgƒgƒŒƒLƒT[ƒg—Ö@‚ɑ΂·‚éƒzƒŠƒi[ƒg‹~‰‡—Ö@Žž‚ĖtáŠQ—\–h‚É‚Í”A‚ĖƒAƒ‹ƒJƒŠ‰ŧ‚Š„§‚ģ‚ę‚é‚ЁH

ƒƒgƒgƒŒƒLƒT[ƒg‚ɑ΂·‚éƒzƒŠƒi[ƒg‹~‰‡—Ö@Žž‚ĖtáŠQ—\–h‚É‚Í”A‚ĖƒAƒ‹ƒJƒŠ‰ŧ‚Š„§‚ģ‚ę‚éB

„§ƒOƒŒ[ƒh
s‚Ī‚ą‚Æ‚ð‹­‚­„§‚·‚é
—v@–ņ

ƒƒgƒgƒŒƒLƒT[ƒg‚ɑ΂·‚éƒzƒŠƒi[ƒg‹~‰‡—Ö@‚ł́C”A‚ĖƒAƒ‹ƒJƒŠ‰ŧ‚Ə\•Š‚Č—A‰t‚É‚æ‚é—˜”A‚ɉÁ‚Ķ‚āCƒƒgƒgƒŒƒLƒT[ƒgŒŒ’†”Z“x‚ðƒ‚ƒjƒ^[‚ĩCŒŒ’†”Z“x‚ɉž‚ķ‚ăzƒŠƒi[ƒg‚Ė‘—Ę‚â“Š—^ŠúŠÔ‚Ė‰„’·‚ðs‚Ī‚ą‚Æ‚Š„§‚ģ‚ę‚éB

”wŒiE–Ú“I

ƒƒgƒgƒŒƒLƒT[ƒg‚ɑ΂·‚éƒzƒŠƒi[ƒg‹~‰‡—Ö@‚Í1970 ”N‘ã‚ÉŠJ”­‚ģ‚ę‚―ŽĄ—Ö@‚Å‚ ‚čC”A‚ĖƒAƒ‹ƒJƒŠ‰ŧ‚â\•Š‚Č—A‰t‚É‚æ‚é—˜”A‚Č‚Į‚ĖŽxŽ—Ö@‚́C‚Ų‚Ú1990 ”N‘ã‚Ü‚Å‚ÉŠm—§‚ĩ‚―•û–@‚Å‚ ‚éB–{e‚ł͍ŋ߂Ė’mŒĐ‚ð‚Ó‚Ü‚Ķ‚āC‚ą‚Ė•û–@‚ɂ‚Ē‚čČŸ“Ē‚·‚éB

‰ð@ā

ƒƒgƒgƒŒƒLƒT[ƒg‚Ė90“ˆČã‚͐t‚Đ‚į”rŸ•‚ģ‚ę‚éB“Ū•ĻŽĀŒą‚ł́CƒƒgƒgƒŒƒLƒT[ƒg‚É‚æ‚étáŠQ‚̓ƒgƒgƒŒƒLƒT[ƒg‚ ‚é‚Ē‚Í‚ŧ‚Ė‘ãŽÓŽY•Ļ‚Å‚ ‚é7-OH-MTX ‚Č‚Į‚Š”AŨŠĮ‚É’ū’…‚·‚é‚ą‚Æ‚É‚æ‚Á‚ÄŽä‹N‚ģ‚ę‚é‚ą‚Æ‚ŠŽĶ‚ģ‚ę‚Ä‚Ē‚éBƒƒgƒgƒŒƒLƒT[ƒg‚Ļ‚æ‚Ņ‚ŧ‚Ė‘ãŽÓŽY•Ļ‚Ė—n‰ð“x‚Í”APH ‚Ɉˑķ‚ĩC6.0 ‚Đ‚į7.0 ‚ɏãļ‚·‚é‚Æ—n‰ð“x‚Í5`8 ”{‚‚­‚Č‚é‚Æ‚ģ‚ę‚Ä‚Ē‚é1jBƒƒgƒgƒŒƒLƒT[ƒg‚ɑ΂·‚éƒzƒŠƒi[ƒg‹~‰‡—Ö@‚Í1970 ”N‘ã‚ÉŠJ”­‚ģ‚ęC‘å—ʁiˆę”Ę“I‚É500`1000 mg/m2ˆČãj‚ĖƒƒgƒgƒŒƒLƒT[ƒg‚ð“Š—^‚·‚é‚ą‚Æ‚É‚æ‚č‚Š‚ņŨ–E‚ÉŽó“Ū“I‚ɃƒgƒgƒŒƒLƒT[ƒg‚ðŽæ‚荾‚Ü‚đCˆę’莞ŠÔŒã‚ɃƒgƒgƒŒƒLƒT[ƒg‰ð“ō܂Ƃĩ‚Ä‚ĖƒzƒŠƒi[ƒg‚ð“Š—^‚·‚é‚ą‚Æ‚É‚æ‚čC‚ą‚ę‚ð”\“Ū“I‚ÉŽæ‚荾‚Þ‚ą‚Æ‚Š‰Â”\‚ȐģíŨ–E‚ð‹~‰‡‚·‚é‚ą‚Ƃ𗝘_“IŠ‹’‚Æ‚·‚éBƒƒgƒgƒŒƒLƒT[ƒg‚ɑ΂·‚éƒzƒŠƒi[ƒg‹~‰‡—Ö@‚́Cœ“ũŽî‚â‹}Ŧ”’ŒŒ•aCˆŦŦƒŠƒ“ƒpŽî‚É—LŒøŦ‚ðŽĶ‚ĩ‚―‚ŠC1970 ”N‘ã‚ĖWŒv‚Å‚ÍŽĄ—Ê֘AŽ€‚Š–ņ6“‚ƍ‚—Ķ‚Å‚ ‚č2jC‚ŧ‚Ė•a‘Ô‚Æ‚ĩ‚ăƒgƒgƒŒƒLƒT[ƒg‚É‚æ‚étáŠQ‚ŠƒƒgƒgƒŒƒLƒT[ƒgŽĐ‘Ė‚Ė”rŸ•’x‰„‚ð‚Ŧ‚―‚ĩCœ‘—}§‚ŧ‚Ė‘ž‚Ėd“Ä‚Č—LŠQŽ–Û‚Š‘‹­‚·‚é‚ą‚Æ‚Šd—vŽ‹‚ģ‚ę‚―2jB‚ŧ‚ĖŒãC”A‚ĖƒAƒ‹ƒJƒŠ‰ŧ3j‚Ə\•Š‚Č—A‰t4j‚É‚æ‚é—˜”A‚ɉÁ‚ĶCƒƒgƒgƒŒƒLƒT[ƒgŒŒ’†”Z“x‚ðƒ‚ƒjƒ^[‚·‚é‚ą‚Æ‚É‚æ‚čŒŒ’†”Z“x‚ɉž‚ķ‚ăzƒŠƒi[ƒg‚Ė‘—Ę‚â“Š—^ŠúŠÔ‚Ė‰„’·‚ðs‚Ī•û–@5j‚Š•‹y‚ĩ‚―B‚ą‚ę‚į‚Ė‹Zp“I‰ü‘P‚É”š‚ĒCƒƒgƒgƒŒƒLƒT[ƒg‚ɑ΂·‚éƒzƒŠƒi[ƒg‹~‰‡—Ö@‚ĖŽĄ—Ê֘AŽ€‚ÍŒļ­‚ĩC2004 ”N‚Ėœ“ũŽî3,887 —á‚ĖWŒvƒf[ƒ^‚Å‚Í0.08“‚Æ•ņ‚ģ‚ę‚Ä‚Ē‚é6jBˆČã‚æ‚čCƒ‰ƒ“ƒ_ƒ€‰ŧ”äŠrŽŽŒą‚É‚æ‚éƒGƒrƒfƒ“ƒX‚Í‚Č‚Ē‚ŠCƒƒgƒgƒŒƒLƒT[ƒg‚ɑ΂·‚éƒzƒŠƒi[ƒg‹~‰‡—Ö@Žž‚ĖtáŠQ—\–h‚ɂ́C”A‚ĖƒAƒ‹ƒJƒŠ‰ŧ‚Ə\•Š‚Č—A‰t‚É‚æ‚é”A—Ę‚ĖŠm•Û‚Š„§‚ģ‚ę‚éBˆę•û‚ŁCãq2004 ”N‚ĖWŒv‚Å‚āƒOƒŒ[ƒh2iWHO Šî€CŒŒīƒNƒŒƒAƒ`ƒjƒ“Šî€”͈͏ãŒĀ~1.5`3.0jˆČã‚Ėt‹@”\áŠQ‚Š68 —ái1.8“j‚ÉŠÏŽ@‚ģ‚ęC‚ŧ‚Ė‚æ‚Ī‚Čę‡‚ĖŽĄ—Ê֘AŽ€‚Š4.4“‚ƈˑR‚Æ‚ĩ‚č‚‚Ē‚ą‚Æ‚Š•ņ‚ģ‚ę‚Ä‚Ē‚é6jBt‹@”\áŠQ‚É‚æ‚郁ƒgƒgƒŒƒLƒT[ƒg‚Ė”rŸ•’x‰„‚ɑ΂ĩ‚ẮCƒzƒŠƒi[ƒg‚Ė‘—Ę‚Š—LŒø‚Æ‚·‚é•ņ‚Š‚ ‚é7jB

‚Ü‚―Å‹ß‚ł́CŒŒ’†ƒƒgƒgƒŒƒLƒT[ƒg‚𒞐ڕŠ‰ð‚·‚郊ƒRƒ“ƒrƒiƒ“ƒgy‘fŧÜ‚Ė—LŒøŦ‚Š‘OŒü‚ŦŽŽŒą8j‚âŒã‚ëŒü‚Ŧ‰ðÍ9j‚Å•ņ‚ģ‚ęC•Ä‘‚ł͏ģ”F‚ģ‚ę‚Ä‚Ē‚é‚ŠC‚í‚Š‘‚Å‚Í–Ēģ”F‚Å‚ ‚éBƒƒgƒgƒŒƒLƒT[ƒg‚Í•ŠŽq—Ę454.44 ‚ƏŽ•ŠŽq‚Å‚ ‚é‚―‚ߌŒ‰t“§Í‚É‚æ‚čœ‹Ž‚Å‚Ŧ‚é‚ŠCƒ^ƒ“ƒpƒNŒ‹‡—Ķ‚Š–ņ50“C•Š•z—eÏ‚Š”10 L ‚Å‚ ‚čC4 ŽžŠÔ‚ĖŒŒ‰t“§Í‚Å‚Ėœ‹Ž—Ķ‚Í10.8“‚Å‚ ‚Á‚―•ņ‚ģ‚ę‚Ä‚Ē‚éiˆã–ō•iî•ņ‚æ‚čjB‚ĩ‚Đ‚ĩHigh-Flux –Œ‚É‚æ‚錌‰t“§Í‚сƒgƒgƒŒƒLƒT[ƒgœ‹ŽŒø—Ķ‚ð‚‚­‚ĩ‚―‚Æ‚Ē‚ĪƒP[ƒXƒVƒŠ[ƒY‚Ė•ņ‚ā‚ ‚č10, 11jCŽĄ—Õû–@‚Ėˆę‚‚Ƃĩ‚čl—ķ‚ĩ‚Ä‚ā‚æ‚ĒB

ˆę•ûC’ʏí—Ę‚ĖƒƒgƒgƒŒƒLƒT[ƒg‚ðŠÜ‚Þ•đ—p‰ŧŠw—Ö@C‚·‚Č‚í‚ŋ“û‚Š‚ņ‚ɑ΂·‚éCMF —Ö@‚â”A˜Hã”į‚Š‚ņ‚ɑ΂·‚éM-VAC —Ö@‚É‚Ļ‚Ē‚āCtáŠQ—\–h‚ð–Ú“I‚Æ‚ĩ‚―ƒzƒŠƒi[ƒg‚â”A‚ĖƒAƒ‹ƒJƒŠ‰ŧ‚Ė—L—pŦ‚ðŽĶ‚·–ūŠm‚ČƒGƒrƒfƒ“ƒX‚Í‚Č‚ĒB‚Ü‚―C’ʏí—Ę‚ĖƒƒgƒgƒŒƒLƒT[ƒg‚ðŠÜ‚Þ•đ—p‰ŧŠw—Ö@ŽĀŽ{Žž‚É”ņƒXƒeƒƒCƒhŦR‰ŠĮ–ō‚ð•đ—p‚ĩ‚―ę‡C—LŠQŽ–Û‚Š‘‹­‚ģ‚ę‚é‚ą‚Æ‚Š•ņ‚ģ‚ę‚Ä‚Ē‚é‚―‚߁CƒƒgƒgƒŒƒLƒT[ƒg‚Æ”ņƒXƒeƒƒCƒhŦR‰ŠĮ–ō‚Ė•đ—p‚Í”ð‚Ŋ‚é‚Ũ‚Ŧ‚Å‚ ‚é1jB

yŽQl•ķŒĢz

1j Widemann BC, et al. Understanding and managing methotrexate nephrotoxici ty. Oncologi s t . 2006G11F694-703. PMIDF16794248

2j Von Hoff DD, et al. Incidence of drug-related deaths secondary to high-dose methotrexate and citrovorum factor administration. Cancer Treat Rep. 1977G61F745-8. PMIDF301783

3j Mir O, et al. Hyper-alkalinization without hyper-hydration for the prevention of high-dose methotrexate acute nephrotoxicity in patients with osteosarcoma. Cancer Chemother Pharmacol. 2010G66F1059-63. PMIDF20155268

4j Romolo JL, et al. Effect of hydration on plasma-methotrexate levels. Cancer Treat Rep. 1977G61F1393-6. PMIDF303939

5j Stoller RG, et al. Use of plasma pharmacokinetics to predict and prevent methotrexate toxicity. N Engl J Med. 1977G297F630-4. PMIDF302412

6j Widemann BC, et al. High-dose methotrexate-induced nephrotoxicity in patients with osteosarcoma. Cancer. 2004G100F2222-32. PMIDF15139068

7j Flombaum CD, et al. High-dose leucovorin as sole therapy for methotrexate toxicity. J Clin Oncol. 1999G17F1589-94. PMIDF10334548

8j Buchen S, et al. Carboxypeptidase G2 rescue in patients with methotrexate intoxication and renal failure. Br J Cancer. 2005G92F480-7. PMIDF15668713

9j Widemann BC, et al. Glucarpidase, leucovorin, and thymidine for high-dose methotrexate-induced renal dysfunctionFclinical and pharmacologic factors affecting outcome. J Clin Oncol. 2010G28F3979-86. PMIDF20679598

10j Wall SM, et al. Effective clearance of methotrexate using high-flux hemodialysis membranes. Am J Kidney Dis. 1996G28F846-54. PMIDF8957036

11j Saland JM, et al. Effective removal of methotrexate by high-flux hemodialysis. Pediatr Nephrol. 2002G17F825-9. PMIDF12376811


C12

ŒŒŠĮVķ‘jŠQ–ō“Š—^Žž‚Ƀ^ƒ“ƒpƒN”A‚ð”F‚ß‚―‚Æ‚Ŧ‚Í‹x–ōEŒļ—Ę‚Š„§‚ģ‚ę‚é‚ЁH

ŒŒŠĮVķ‘jŠQ–ō“Š—^Žž‚Ƀ^ƒ“ƒpƒN”A‚ð”F‚ß‚―‚Æ‚Ŧ‚́Cƒ^ƒ“ƒpƒN”A‚ĖƒOƒŒ[ƒh‚Æ–ō•ĻŽĄ—ÃŒp‘ą‚ĖƒŠƒXƒNEƒxƒlƒtƒBƒbƒg‚ð‰Á–Ą‚ĩ‚―‚Ī‚Ķ‚Å‚Ė‹x–ōEŒļ—Ę‚Š„§‚ģ‚ę‚éB

„§ƒOƒŒ[ƒh
s‚Ī‚ą‚Æ‚ð‹­‚­„§‚·‚é
—v@–ņ

@ŒŒŠĮVķ‘jŠQ–ō‚ð“Š—^‚·‚éÛ‚ɂ́C’čŠú“I‚ČŒŒˆģ‘Š’č‚Æ”AŒŸļ‚É‚æ‚鍂ŒŒˆģCƒ^ƒ“ƒpƒN”A‚Ė‘Šú”­ŒĐ‚ɉÁ‚Ķ‚āC~ˆģ–ō‚ĖÏ‹É“Š—^‚É‚æ‚é\•Š‚ČŒŒˆģƒRƒ“ƒgƒ[ƒ‹‚ðs‚ĪBƒ^ƒ“ƒpƒN”A‚ŠoŒŧ‚ĩ‚―Û‚́CŽĄ—Öō‚ĖˆęŽž‹x–ō‚âŒļ—Ę‚ĩ‚Ä‚ĖŽĄ—ÃŒp‘ą‚ÍŒŧŽĀ“I‚Č‘I‘ðŽˆ‚Å‚ ‚é‚ŠCƒOƒŒ[ƒh1 ‚Ėƒ^ƒ“ƒpƒN”A‚Å‚ ‚ę‚΁Cis‚Š‚ņŠģŽŌ‚ɑ΂·‚鎥—ʃXƒN‚ƃxƒlƒtƒBƒbƒg‚ð‰Á–Ą‚ĩ‚―‚Ī‚Ķ‚ŁCŽĄ—ÃŒp‘ą‚āl—ķ‚·‚éBƒOƒŒ[ƒh2 ˆČã‚Ėƒ^ƒ“ƒpƒN”A‚ŠoŒŧ‚ĩ‚―ę‡‚É‚ÍˆęŽž‹x–ō‚âŒļ—Ę‚ðs‚ĒC•K—v‚ɉž‚ķ‚Đt‘Ÿę–åˆã‚Ö‰î“ü‚ðˆË—Š‚·‚éB

”wŒiE–Ú“I

ŒŒŠĮVķ‘jŠQ–ō‚ÍŽíX‚Ė‚Š‚ņŽî‚ŗՏ°“ą“ü‚ģ‚ę‚Ä‚Ļ‚čC‚Ļ‚ā‚ÉVEGF Œo˜H‚Ė—}§‚É‚æ‚Á‚ÄŽîᇂĖŒŒŠĮVķ‚ð‘jŠQ‚·‚éB‚ŧ‚Ė–ōŒø‚Æ—LŠQŽ–Û‚́CŨ–EáŠQŦR‚Š‚ņ–ō‚Ƃ͈Ų‚Č‚éƒpƒ^[ƒ“‚ðŽĶ‚·Bƒ^ƒ“ƒpƒN”A‚͍‚ŒŒˆģ‚É•Ā‚ŅCŒŒŠĮVķ‘jŠQ–ō‚É‚æ‚鎥—Ã’†‚ɐķ‚ķ‚é—LŠQŽ–Û‚Ėˆę‚‚ł ‚é1jBƒ^ƒ“ƒpƒN”A‚â”ũ—ĘƒAƒ‹ƒuƒ~ƒ“”A‚ĖoŒŧ‚́Ct‹@”\áŠQ‚âSŒŒŠĮ‡•đĮ‚Ė“Æ—§‚ĩ‚―ƒŠƒXƒNˆöŽq‚Å‚ ‚é‚ą‚Æ‚Š–ū‚į‚Đ‚É‚ģ‚ę‚Ä‚Ļ‚č2jCŒŒŠĮVķ‘jŠQ–ō“Š—^Žž‚Ƀ^ƒ“ƒpƒN”A‚ŠoŒŧ‚ĩ‚―Û‚āC“KØ‚ČŠĮ—‚Š•K—v‚Æ‚ģ‚ę‚éBŒŒŠĮVķ‘jŠQ–ō‚É‚Í‚ģ‚Ü‚ī‚Ü‚ČŽí—Þ‚Š‚ ‚čC“K‰ž‚Æ‚Č‚é‚Š‚ņŽî‚⎥—ɃCƒ“‚āˆŲ‚Č‚Á‚Ä‚Ē‚éBisŦtŨ–E‚Š‚ņ‚Ė‚æ‚Ī‚ɁC–ō•ĻŽĄ—ÊJŽnŽž‚É‚Ų‚Æ‚ņ‚Į‚ĖĮ—á‚Š’Pt‚Å‚ ‚é‚æ‚Ī‚Č‚Š‚ņŽî‚ɑ΂ĩ‚Ä‚āŒŒŠĮVķ‘jŠQ–ō‚Í“Š—^‚ģ‚ę‚Ä‚Ē‚éB‚ģ‚į‚ɂ́CŒŒŠĮVķ‘jŠQ–ō‚Í’PÜ‚Å“Š—^‚ģ‚ę‚éę‡‚ā‚ ‚ę‚Α―Ü•đ—p—Ö@‚Ėˆę•”‚Æ‚ĩ‚Ä—p‚Ē‚į‚ę‚é‚ą‚Æ‚ā‚ ‚éB‚ą‚Ė‚æ‚Ī‚Č‘―—l‚Č”wŒi‚ā‚ ‚čCŒŒŠĮVķ‘jŠQ–ō“Š—^’†‚Ėƒ^ƒ“ƒpƒN”A‚ĖoŒŧ•p“x‚Í–ōÜ‚ē‚ƂɈŲ‚Č‚é‚ą‚Æ‚Š–ū‚į‚Đ‚É‚ģ‚ę‚Ä‚Ē‚é1jB‘“ā‚Ė“Á’čŽg—pŽŅ’ēļ‚æ‚é‚ƁCisŦŒ‹’°E’ž’°‚Š‚ņ2,696 —á‚ɑ΂·‚éƒxƒoƒVƒYƒ}ƒu“Š—^’†‚Ėƒ^ƒ“ƒpƒN”AoŒŧ•p“x‚Í4.60“‚Å‚ ‚čC‚ŧ‚Ė‚Ī‚ŋd“Ä‚Č‚ā‚Ė‚Í0.11“‚Æ•ņ‚ģ‚ę‚Ä‚Ē‚é3jBisŦtŨ–E‚Š‚ņ‚Ļ‚æ‚ŅÁ‰ŧŠĮŠÔŽŋŽîá‡2,141 —á‚ɑ΂·‚éƒXƒjƒ`ƒjƒu“Š—^’†‚Ėƒ^ƒ“ƒpƒN”AoŒŧ•p“x‚Í1.59“‚ŁCisŦtŨ–E‚Š‚ņ‚Å‚ĖoŒŧ•p“x‚Í1.20“CÁ‰ŧŠĮŠÔŽŋŽîᇂłÍ2.98“‚Æ•ņ‚ģ‚ę‚Ä‚Ē‚é4jBisŦtŨ–E‚Š‚ņ3,335 —á‚ɑ΂·‚éƒ\ƒ‰ƒtƒFƒjƒu“Š—^’†‚Ėƒ^ƒ“ƒpƒN”AoŒŧ•p“x‚Í0.71“‚ŁCd“Ä—á‚Í•ņ‚ģ‚ę‚Ä‚Ē‚Č‚Ē5jB“ú–{l‚ĖƒTƒCƒgƒJƒCƒ“—Ö@•s‰žŦisŦtŨ–E‚Š‚ņ64 —á‚ɑ΂·‚éƒAƒLƒVƒ`ƒjƒu‚Ė‘æⅡ‘Š—Տ°ŽŽŒą‚ł́Cƒ^ƒ“ƒpƒN”A‚ĖoŒŧ•p“x‚Í58“‚ŁC‚ŧ‚Ė‚Ī‚ŋ9“‚ŠƒOƒŒ[ƒh3 ˆČã‚Ėd“Ä—á‚Å‚ ‚Á‚―‚Æ•ņ‚ģ‚ę‚Ä‚Ē‚é6jB

‰ð@ā

ŒŒŠĮVķ‘jŠQ–ō‚·‚Č‚í‚ŋVEGF Œo˜H‚Ė‘jŠQ–ō‚É‚æ‚鎥—Ã’†‚ɐķ‚ķ‚éƒ^ƒ“ƒpƒN”A‚ĖģŠm‚Č”­ĮƒƒJƒjƒYƒ€‚Í–ū‚į‚Đ‚É‚ģ‚ę‚Ä‚Ē‚Č‚Ē‚ŠCŽ…‹…‘Ėã”įŨ–E‚ĖVEGF ŽYķ‚Š‘jŠQ‚ģ‚ę‚é‚ą‚Æ‚É—R—ˆ‚·‚鎅‹…‘Ė\‘Ē‚Æāh‰ß‹@”\‚Ė”j’]‚Š„‘Š‚ģ‚ę‚Ä‚Ē‚é7jBACE‘jŠQ–ō‚âARB ‚É‚Í—AoŨ“Ū–Ž‚ðŠg’Ģ‚ģ‚đŽ…‹…‘Ė“āˆģ‚ð’ቚ‚ģ‚đƒ^ƒ“ƒpƒN”A‚ðŒļ­‚ģ‚đ‚éė—p‚Š‚ ‚é‚ą‚Æ‚Đ‚įCŒŒŠĮVķ‘jŠQ–ō‚ð“Š—^‚·‚éÛ‚É‚Í’čŠú“I‚ČŒŒˆģ‘Š’č‚ƃ^ƒ“ƒpƒN”AŒŸļ‚É‚æ‚鑁Šú”­ŒĐ‚ɉÁ‚Ķ‚āC~ˆģ–ō‚ĖÏ‹É“Š—^‚É‚æ‚é\•Š‚ČŒŒˆģƒRƒ“ƒgƒ[ƒ‹‚Šs‚í‚ę‚Ä‚Ē‚é1jB

ŒŒŠĮVķ‘jŠQ–ō‚ē‚ƂɃ^ƒ“ƒpƒN”A‚ĖoŒŧ•p“x‚͈Ų‚Č‚é‚ā‚Ė‚ĖC”Aƒ^ƒ“ƒpƒN‚Í—p—ĘˆË‘ķŦ‚É‹N‚ą‚é‚ƍl‚Ķ‚į‚ę‚Ä‚Ē‚é8, 9jB‚ŧ‚Ė‚―‚߁Cƒ^ƒ“ƒpƒN”A‚ŠoŒŧ‚ĩ‚―Û‚ɂ́CŒŒŠĮVķ‘jŠQ–ō‚ĖŒļ—Ę‚âˆęŽž‹x–ō‚ŠŒŧŽĀ“I‚Č‘I‘ðŽˆ‚Å‚ ‚éBŽĀÛCŠeŽí•ŠŽq•W“I–ō‚ĖŽĄ—ÃŒø‰Ę‚ðŒŸ“Ē‚·‚é—Տ°ŽŽŒą‚Å‚āC–ōÜ“Š—^’†‚ɃOƒŒ[ƒh2 ˆČã‚Ėƒ^ƒ“ƒpƒN”A‚ŠoŒŧ‚ĩ‚―ę‡‚É‚ÍŒļ—Ę‚Ü‚―‚Í‹x–ō‚ĩ‚Ä‚Đ‚įÄ“Š—^‚·‚é‚ą‚Æ‚Š‘―‚Ē10jB—\Œã‚ĖŒĀ‚į‚ę‚―is‚Š‚ņŠģŽŌ‚ɑ΂·‚鎥—Ã’†‚ɃOƒŒ[ƒh1 ‚Ėƒ^ƒ“ƒpƒN”A‚Šķ‚ķ‚―ę‡C‚·‚Ũ‚Ä‚ĖĮ—á‚Å‹x–ō‚âŒļ—Ę‚Š•K—v‚Æ‚ÍŒĀ‚į‚ļC–ō•ĻŽĄ—ÃŒp‘ą‚Ė—˜‰v/•s—˜‰v‚ðŒŸ“Ē‚ĩCŠģŽŌ‚ĖŠó–]‚āl—ķ‚ĩ‚Ä”ŧ’f‚·‚é•K—v‚Š‚ ‚éB‚ĩ‚Đ‚ĩ‚Č‚Š‚įŠeŽíŒŒŠĮVķ‘jŠQ–ō‚Ė“Š—^’†‚Ƀlƒtƒ[ƒ[ĮŒóŒQ‚𔭏Į‚ĩ‚―Į—á‚ŠŠm”F‚ģ‚ę‚Ä‚Ļ‚č11-13jCˆęŽž‹x–ō‚âŒļ—Ę‚ð‚ĩ‚Ä‚āƒ^ƒ“ƒpƒN”A‚Š‘ˆŦ‚·‚é‚æ‚Ī‚Čę‡‚ɂ͐t‘Ÿę–åˆã‚Æ‚Ė˜AŒg‚É‚æ‚鎥—Âāl—ķ‚·‚Ũ‚Ŧ‚Å‚ ‚é1jB

yŽQl•ķŒĢz

1j Izzedine H, et al. VEGF signalling inhibition-induced proteinuriaF Mechanisms, significance and management. Eur J Cancer. 2010G46F439-48. PMIDF20006922

2j Kandula P, et al. Proteinuria and hypertension with tyrosine kinase inhibitors. Kidney Int. 2011G80F1271-7. PMIDF21900879

3j ƒAƒoƒXƒ`ƒ“® “_“HÃ’—p@“Á’čŽg—pŽŅ’ēļÅI‰ðÍŒ‹‰ĘDŽĄ–üØœ•s”\‚ȐisEÄ”­‚ĖŒ‹’°E’ž’°Šā‚ð‘ΏۂƂĩ‚―‘S—á’ēļD

4j ƒX[ƒeƒ“ƒg® ƒJƒvƒZƒ‹12.5 mg “Á’čŽg—pŽŅ’ēļÅI•ņ‘D2012 ”N3 ŒŽėŽD

5j ƒlƒNƒTƒo[ƒ‹® ų200 mgiˆę”Ę–žFƒ\ƒ‰ƒtƒFƒjƒuƒgƒVƒ‹Ž_‰–ųj“Á’čŽg—pŽŅ’ēļÅI•ņ‘D2012 ”N10 ŒŽD

6j Tomita Y, et al.Gfor the Japan Axitinib Phase Ⅱ Study Group. Key predictive factors of axitinibiAG-013736j-induced proteinuria and efficacyFa phase Ⅱ study in Japanese patients with cytokine-refractory metastatic renal cell Carcinoma. Eur J Cancer. 2011G47F2592-602. PMIDF21889330

7j Wu S, et al. Antiangiogenic agents for the treatment of nonsmall cell lung cancerFcharacterizing the molecular basis for serious adverse events. Cancer Invest. 2011G29F460-71. PMIDF21740083

8j Wu S, et al. Bevacizumab increases risk for severe proteinuria in cancer patients. J Am Soc Nephrol. 2010G21F1381-9. PMIDF20538785

9j Land JD, et al. Proteinuria with first-line therapy of metastatic renal cell cancer. J Oncol Pharm Pract. 2016G22F235-41. PMIDF25505255

10j Hainsworth JD, et al. Phase Ⅱ trial of bevacizumab and everolimus in patients with advanced renal cell carcinoma. J Clin Oncol. 2010G28F2131-6. PMIDF20368560

11j Overkleeft EN, et al. Nephrotic syndrome caused by the angiogenesis inhibitor sorafenib. Ann Oncol. 2010G21F184-5. PMIDF19889617

12j Eremina V, et al. VEGF inhibition and renal thrombotic microangiopathy. N Engl J Med. 2008G358F1129-36. PMIDF18337603

13j Costero O, et al. Inhibition of tyrosine kinases by sunitinib associated with focal segmental glomerulosclerosis lesion in addition to thrombotic microangiopathy. Nephrol Dial Transplant. 2010G25F1001-3. PMIDF20019017


CQ13

ƒrƒXƒzƒXƒzƒl[ƒgŧÜCRRANKL R‘Ė‚͐t‹@”\‚Š’ቚ‚ĩ‚―ŠģŽŌ‚ɑ΂ĩ‚Ä‚ÍŒļ—Ę‚Š„§‚ģ‚ę‚é‚ЁH

ƒrƒXƒzƒXƒzƒl[ƒgŧÜ‚́Ct‹@”\‚Š’ቚ‚ĩ‚―ŠģŽŌ‚ɑ΂ĩ‚ÄŒļ—Ę‚Š„§‚ģ‚ę‚éBˆę•ûCRRANKL R‘Ė‚́Ct‹@”\‚Š’ቚ‚ĩ‚―ŠģŽŌ‚ɑ΂ĩ‚ÄŒļ—Ę‚Š„§‚ģ‚ę‚Č‚ĒB

„§ƒOƒŒ[ƒh
s‚Ī‚ą‚Æ‚ð‹­‚­„§‚·‚é
—v@–ņ

ƒrƒXƒzƒXƒzƒl[ƒgŧÜ‚́Ct‹@”\‚Š’ቚ‚ĩ‚―ŠģŽŌ‚ɑ΂ĩ‚ÄŒļ—Ę‚Š„§‚ģ‚ę‚éBˆę•ûCRRANKL R‘Ė‚́Ct‹@”\‚Š’ቚ‚ĩ‚―ŠģŽŌ‚ɑ΂ĩ‚ÄŒļ—Ę‚Š„§‚ģ‚ę‚Č‚ĒB

”wŒiE–Ú“I

’ŽË—pƒrƒXƒzƒXƒzƒl[ƒgŧÜ‚́CˆŦŦŽîᇂɂæ‚鍂ƒJƒ‹ƒVƒEƒ€ŒŒĮ‚Ė‰ü‘PC‘―”­Ŧœ‘Žî‚ ‚é‚Ē‚͌Ō`‚Š‚ņœ“]ˆÚ‚É‚æ‚鍜•a•Ï‚ɑ΂·‚鍜ŠÖ˜AƒCƒxƒ“ƒgi•a“IœÜCœ•a•Ï‚ɑ΂·‚é•úŽËüŽĄ—ÁCœ•a•Ï‚ɑ΂·‚éŠO‰Č“IŽčpCŌ‘ˆģ”—C‚ƒJƒ‹ƒVƒEƒ€ŒŒĮ‚Æ’č‹`j‚Ė—}§‚É‚Ļ‚Ŋ‚é—L—pŦ‚ŠŠm—§‚ĩ‚Ä‚Ē‚éB‚í‚Š‘‚ňŦŦŽîᇂɎg—p‚ģ‚ę‚Ä‚Ē‚é‚Ė‚́CŽå‚Æ‚ĩ‚ă]ƒŒƒhƒƒ“Ž_‚ƃpƒ~ƒhƒƒ“Ž_‚Å‚ ‚čCƒpƒ~ƒhƒƒ“Ž_‚͈ŦŦŽîᇂɂæ‚鍂ƒJƒ‹ƒVƒEƒ€ŒŒĮ‚Æ“û‚Š‚ņ‚Ė—nœŦœ“]ˆÚ‚ɑ΂ĩCƒ]ƒŒƒhƒƒ“Ž_‚͈ŦŦŽîᇂɂæ‚鍂ƒJƒ‹ƒVƒEƒ€ŒŒĮC‘―”­Ŧœ‘Žî‚ ‚é‚Ē‚͌Ō`‚Š‚ņœ“]ˆÚ‚É‚æ‚鍜•a•Ï‚ɑ΂ĩģ”F‚ģ‚ę‚Ä‚Ē‚éB‚ŧ‚Ė‘žC‰ĒB‚ł̓Cƒoƒ“ƒhƒƒ“Ž_‚ĖÃ–Ž’ŽËŧÜ‚ŠCœ“]ˆÚŠÖ˜AƒCƒxƒ“ƒg—}§–Ú“I‚ɏģ”F‚ģ‚ę‚Ä‚Ē‚éBƒrƒXƒzƒXƒzƒl[ƒgŧÜ‚Ė—LŠQŽ–Û‚Ė‚ЂƂ‚ɐt‹@”\áŠQ‚Š’m‚į‚ę‚Ä‚Ļ‚čC–{e‚ł͐t‹@”\‚ɉž‚ķ‚―Œļ—Ę‚Ė•K—vŦ‚ÉŠÖ‚ĩ‚ÄŒŸ“Ē‚·‚éB

‰ð@ā

‚—p—ʁi90`360 mg/ŒŽj‚Ėƒpƒ~ƒhƒƒ“Ž_“Š—^‚Í‘ƒóŽ…‹…‘Ėd‰ŧĮ‚â‹}Ŧ”AŨŠĮ‰óŽ€‚ðķ‚ķC‹}Ŧt•s‘S‚âƒlƒtƒ[ƒ[ĮŒóŒQ‚ɐis‚·‚é‚ą‚Æ‚Š•ņ‚ģ‚ę‚―1jB‚ŧ‚ĖŒãC—p—Ę‚â“Š—^ŽžŠÔ‚ÉŠÖ‚·‚錟“Ē‚É‚æ‚čCƒpƒ~ƒhƒƒ“Ž_90 mg ‚ð3 ŽžŠÔˆČã‚Đ‚Ŋ‚Ä“Š—^‚ĩ‚―‚Æ‚Ŧ‚ɂ͐t‹@”\áŠQ‚ÍŒy“x‚Å‚ ‚čC‘æⅢ‘ŠŽŽŒą‚Å‚āCƒvƒ‰ƒZƒ{‚É”äŠr‚ĩ‚Ä—LˆÓ‚Ȑt‹@”\áŠQ‚Š”F‚ß‚į‚ę‚Č‚Đ‚Á‚―B‚ą‚ĖŒ‹‰Ę‚ÉŠî‚ÂŦC•Ä‘—Տ°Žîᇊw‰ïiASCOj‚ĖƒKƒCƒhƒ‰ƒCƒ“‚Š‰ü’ų‚ģ‚ęCƒpƒ~ƒhƒƒ“Ž_90 mg ‚ð2 ŽžŠÔˆČã‚Đ‚Ŋ‚Ä“Š—^‚·‚é‚Ė‚Å‚ ‚ę‚΁CCcr ‚Š30`60 mL/•Š‚Ėę‡‚Å‚āƒpƒ~ƒhƒƒ“Ž_‚ĖŒļ—Ę‚Ė•K—v‚Í‚Č‚­CCcr ‚Š30 mL/•ŠˆČ‰š‚Ėę‡‚̓pƒ~ƒhƒƒ“Ž_‚Ė“Š—^ŽžŠÔ‚ð‚ģ‚į‚ɉ„’·i4`6 ŽžŠÔj‚·‚é‚ЁC‚ ‚é‚Ē‚ÍŒļ—Ę‚ðl—ķ‚·‚é‚ą‚Æ‚Š–ū‹L‚ģ‚ę‚―2, 3jB

ƒ]ƒŒƒhƒƒ“Ž_‚́C—nœŦ•Ï‰ŧ‚ð—L‚·‚é“û‚Š‚ņC‘―”­Ŧœ‘ŽîC”x‚Š‚ņC‚ŧ‚Ė‘ž‚ĖŒÅŒ`ŽîᇂȂĮ‚ð‘ΏۂƂĩ‚―‚Ē‚­‚‚ЂĖ‘æⅢ‘ŠŽŽŒą‚É‚Ļ‚Ē‚āC4 mg ‚Ü‚―‚Í8 mg ‚ð5 •ŠŠÔ‚Å“Š—^‚Æ‚Ē‚ĪƒvƒƒgƒR[ƒ‹‚ÅŠJŽn‚ģ‚ę‚―‚ŠC8 mg ‚ð5 •ŠŠÔ‚Å“Š—^‚ĩ‚―ŒQ‚ɐt‹@”\áŠQ‚Š‚•p“x‚É”F‚ß‚į‚ę‚―‚―‚߂ɁC2 ’iŠK‚ĖƒvƒƒgƒR[ƒ‹‰üģ‚Š•K—v‚Æ‚Č‚Á‚―B‘æˆę‚É5 •ŠŠÔ‚Đ‚į15 •ŠŠÔ‚Ö‚Ė“Š—^ŽžŠÔ‚Ė‰„’·C‘æ“ņ‚É8 mg “Š—^‚Ė’†Ž~‚Ļ‚æ‚Ņ4 mg “Š—^‚Ö‚Ė•ÏX‚Å‚ ‚čC‚ą‚ę‚į‚Ė‰ü’ų‚É‚æ‚čt‹@”\áŠQ‚Ė•p“x‚̓vƒ‰ƒZƒ{‚ ‚é‚Ē‚͑ΏƌQ‚Å‚ ‚éƒpƒ~ƒhƒƒ“Ž_‚Æ“Ŋ“™‚É‚Č‚Á‚―4-8jB2005 ”N‚Ƀmƒoƒ‹ƒeƒBƒXƒtƒ@[ƒ}ŽÐ‚ÍFDA ‚É“Y•t•ķ‘‰ü’ų‚ð\ŋ‚ĩCCcr ‚Š30`60 mL/•Š‚Ėt‹@”\’ቚŠģŽŌ‚Ö‚Ė“Š—^‚ÉŠÖ‚ĩ‚āCCcr ‚Š75 mL/•Š‚ĖŠģŽŌ‚Æ“Ŋ“™‚ĖAUC ‚Š“ū‚į‚ę‚é‚æ‚Ī‚Ƀ]ƒŒƒhƒƒ“Ž_“Š—^—Ę‚ĖŒļ—Ę‚ŠÝ’č‚ģ‚ę‚―iCcr ‚Š50`60 mL/•Š‚Ėę‡3.5 mgCCcr ‚Š40`49 mL/•Š‚Ėę‡3.3 mgCCcr ‚Š30`39 mL/•Š‚Ėę‡3.0 mgjB‰ü’ų‚ģ‚ę‚―ASCO ƒKƒCƒhƒ‰ƒCƒ“‚ł́Cƒ]ƒŒƒhƒƒ“Ž_‚Í4 mg ‚ð15 •ŠˆČã‚Đ‚Ŋ‚Ä“Š—^‚·‚é‚ą‚ƁCCcr ‚Š30`60 mL/•Š‚Ėę‡C“Y•t•ķ‘‚Ė„§‚É‚ĩ‚―‚Š‚Á‚ÄŒļ—Ę‚·‚é‚ą‚ƁCCcr ‚Š30 mL/•ŠˆČ‰š‚Ėę‡‚̓]ƒŒƒhƒƒ“Ž_“Š—^‚𐄏§‚ĩ‚Č‚Ē‚ą‚Æ‚Š–ū‹L‚ģ‚ę‚―BShah ‚į‚É‚æ‚é220 —á‚ĖŒã‚ëŒü‚Ŧ‰ðÍ‚ł́C“Y•t•ķ‘‚Ė„§‚É‚ĩ‚―‚Š‚Á‚ă]ƒŒƒhƒƒ“Ž_‚Ė—p—Ę’ēß‚ðs‚Á‚―ę‡Ct‹@”\’ቚŠģŽŌ‚ƐģíŠģŽŌ‚É‚Ļ‚Ŋ‚éC—LŠQŽ–Û‚Æ‚ĩ‚Ä‚Ė‹}Ŧt•s‘S‚Ė•p“x‚Í“Ŋ“™‚Å‚ ‚Á‚―‚Æ•ņ‚ģ‚ę‚―9jB

ƒCƒoƒ“ƒhƒƒ“Ž_‚́CÃ–Ž’ŽËŧÜ‚Š‰ĒB‚ɂďģ”F‚ģ‚ęCœ“]ˆÚ‚ĖœŠÖ˜AƒCƒxƒ“ƒg—}§–Ú“I‚ÉŽg—p‚ģ‚ę‚Ä‚Ē‚éi‚í‚Š‘‚ł͍œ‘e頏Į‚ɑ΂ĩŒoŒû–ō‚Ė‚ݏģ”FjBƒCƒoƒ“ƒhƒƒ“Ž_‚͐t‹@”\áŠQ‚Ė•p“x‚ŠƒrƒXƒzƒXƒzƒl[ƒgÃ–Ž’ŽËŧÜ‚Ė‚Č‚Đ‚Å‚Í‚ā‚Á‚Æ‚ā’á‚Ē‚Æ‚ģ‚ę‚Ä‚Ē‚é10jB‚ĩ‚Đ‚ĩCCcr ‚Š50 mL/•ŠˆČ‰š‚Ėę‡C“Š—^ŽžŠÔ‚ð15 •Š‚Đ‚į1 ŽžŠÔ‚ɉ„’·‚·‚é‚ą‚ƁCCcr ‚Š30 mL/•ŠˆČ‰š‚Ėę‡‚Í6 mg “Š—^‚Đ‚į2 mg “Š—^‚ÉŒļ—Ę‚·‚é‚ą‚Æ‚Š“Y•t•ķ‘‚Ő„§‚ģ‚ę‚Ä‚Ē‚éB

œ“]ˆÚ‚ɑ΂·‚鎥—Öō‚Æ‚ĩ‚āCRRANKL R‘Ė‚ŠŠJ”­‚ģ‚ęC‘æⅢ‘ŠŽŽŒą‚É‚Ļ‚Ē‚āCƒ]ƒŒƒhƒƒ“Ž_‚æ‚č‚ā—LˆÓ‚ɍœŠÖ˜AƒCƒxƒ“ƒg‚Ė”­ķ‚ð—}§‚ĩ‚―B—LŠQŽ–Û‚Æ‚ĩ‚Đt‹@”\áŠQ‚Í‚Č‚­Ct‹@”\‚ɉž‚ķ‚―—p—Ę’ēß‚Ė•K—v‚Í‚Č‚Ē‚Æ‚ģ‚ę‚Ä‚Ē‚é11jB‚―‚ū‚ĩCCcr 30 mL/•Š–Ē–ž‚ĖŠģŽŌ‚Ļ‚æ‚Ņ“§Í‚Ė•K—v‚ČESRD ŠģŽŌ‚͗Տ°ŽŽŒą‚Ė‘ÎÛ‚Đ‚įœŠO‚ģ‚ę‚Ä‚Ē‚é‚―‚߁Cd“Ä‚Č’áƒJƒ‹ƒVƒEƒ€ŒŒĮ‚Š”­Į‚·‚é‰Â”\Ŧ‚ðl—ķ‚ĩCd“x‚Ėt‹@”\áŠQŠģŽŌ‚ł͍RRANCL R‘Ė‚Ė“K‰ž‚ðTd‚É”ŧ’f‚·‚é•K—v‚Š‚ ‚éB

yŽQl•ķŒĢz

1j Markowitz GS, et al. Collapsing focal segmental glomerulosclerosis following treatment with high-dose pamidronate. J Am Soc Nephrol. 2001G12F1164-72. PMIDF11373339

2j Hillner BE, et al.Gfor the American Society of Clinical Oncology. American Society of Clinical Oncology 2003 update on the role of bisphosphonates and bone health issues in women with breast cancer. J Clin Oncol. 2003G21F4042-57. PMIDF12963702

3j Kyle RA, et al.Gfor the American Society of Clinical Oncology. American Society of Clinical Oncology 2007 clinical practice guideline update on the role of bisphosphonates in multiple myeloma. J Clin Oncol. 2007G25F2464-72. PMIDF17515569

4j Rosen LS, et al. Zoledronic acid versus pamidronate in the treatment of skeletal metastases in patients with breast cancer or osteolytic lesions of multiple myelomaFa phase Ⅲ, double-blind, comparative trial. Cancer J. 2001G7F377-87. PMIDF11693896

5j Rosen LS, et al. Zoledronic acid is superior to pamidronate for the treatment of bone metastases in breast carcinoma patients with at least one osteolytic lesion. Cancer. 2004G100F36-43. PMIDF14692022

6j Rosen LS, et al. Long-term efficacy and safety of zoledronic acid compared with pamidronate disodium in the treatment of skeletal complications in patients with advanced multiple myeloma or breast carcinomaFa randomized, double-blind, multicenter, comparative trial. Cancer. 2003G98F1735-44. PMIDF14534891

7j Rosen LS, et al. Zoledronic acid versus placebo in the treatment of skeletal metastases in patients with lung cancer and other solid tumorsFa phase Ⅲ, double-blind, randomized trial--the Zoledronic Acid Lung Cancer and Other Solid Tumors Study Group. J Clin Oncol. 2003G21F3150-7. PMIDF12915606

8j Rosen LS, et al. Long-term efficacy and safety of zoledronic acid in the treatment of skeletal metastases in patients with nonsmall cell lung carcinoma and other solid tumorsFa randomized, Phase Ⅲ, double-blind, placebo-controlled trial. Cancer. 2004G100F2613-21. PMIDF15197804

9j Shah SR, et al. Risk of renal failure in cancer patients with bone metastasis treated with renally adjusted zoledronic acid. Support Care Cancer. 2012G20F87-93. PMIDF21197550

10j Pivot X, et al. Renal safety of ibandronate 6 mg infused over 15 min versus 60 min in breast cancer patients with bone metastasesFa randomized open-label equivalence trial. Breast. 2011G20F510-4. PMIDF21727006

11j Henry DH, et al. Randomized, double-blind study of denosumab versus zoledronic acid in the treatment of bone metastases in patients with advanced canceriexcluding breast and prostate cancerjor multiple myeloma. J Clin Oncol. 2011G29F1125-32. PMIDF21343556


i4jˆÛŽ“§ÍŠģŽŌ

C14

ˆÛŽ“§ÍŠģŽŌ‚ɑ΂ĩ‚ăVƒXƒvƒ‰ƒ`ƒ““Š—^Œã‚É–ō•Ļœ‹Ž–Ú“I‚É“§Í—Ö@‚ðs‚Ī‚ą‚Ƃ͐„§‚ģ‚ę‚é‚ЁH

‘gD‚âƒ^ƒ“ƒpƒN‚ÉŒ‹‡‚ĩ‚Ä‚Ē‚éƒVƒXƒvƒ‰ƒ`ƒ“‚Ė‘å•”•Š‚Í“§Í‚ðs‚Á‚Ä‚ā‘Ė“ā‚ÉŽc‚čC“§ÍŒã‚ɃŠƒoƒEƒ“ƒh‚É‚æ‚éÄãļ‚Š”F‚ß‚į‚ę‚é‚―‚߁CˆÛŽ“§ÍŠģŽŌ‚ɑ΂ĩ‚ăVƒXƒvƒ‰ƒ`ƒ““Š—^Œã‚Ƀ^ƒCƒ~ƒ“ƒO‚ÉŠÖ‚í‚į‚ļ–ō•Ļœ‹Ž–Ú“I‚Ė“§Í—Ö@‚ðs‚Ī‚ą‚Ƃ͐„§‚ģ‚ę‚Č‚ĒB

„§ƒOƒŒ[ƒh
s‚í‚Č‚Ē‚ą‚Æ‚ðŽã‚­„§‚·‚éi’ņˆÄ‚·‚éj
—v@–ņ

‘gD‚âƒ^ƒ“ƒpƒN‚ÉŒ‹‡‚ĩ‚Ä‚Ē‚éƒVƒXƒvƒ‰ƒ`ƒ“‚Ė‘å•”•Š‚Í“§Í‚ðs‚Á‚Ä‚ā‘Ė“ā‚ÉŽc‚čC“§ÍŒã‚ɃŠƒoƒEƒ“ƒh‚É‚æ‚éÄãļ‚Š”F‚ß‚į‚ę‚é‚―‚߁CˆÛŽ“§ÍŠģŽŌ‚ɑ΂ĩ‚ăVƒXƒvƒ‰ƒ`ƒ““Š—^Œã‚ɁCƒ^ƒCƒ~ƒ“ƒO‚ÉŠÖ‚í‚į‚ļ–ō•Ļœ‹Ž–Ú“I‚Ė“§Í—Ö@‚ðs‚Ī‚ą‚Ƃ͐„§‚ģ‚ę‚Č‚ĒB‚―‚ū‚ĩC‚ą‚ę‚͏Į—á•ņ‚ÉŠî‚­ƒGƒLƒXƒp[ƒgƒIƒsƒjƒIƒ“‚Å‚ ‚čCƒGƒrƒfƒ“ƒX\f—ÃMƒƒƒbƒv‚ð‰ðÁ‚·‚é‚―‚߂ɍĄŒã‚ģ‚į‚Č‚é—Տ°ŒĪ‹†‚Š•K—v‚Å‚ ‚éB

”wŒiE–Ú“I

ESRD ŠģŽŌ‚ł́CƒVƒXƒvƒ‰ƒ`ƒ“‚Ė“Š—^Œã‚É’~Ï“ŐŦ‚ɑ΂·‚錜”O‚Đ‚į–ō•Ļœ‹Ž–Ú“I‚É“§Í‚ðs‚Īę‡‚ā‚ ‚é‚ÆŽv‚í‚ę‚éB‚ŧ‚ą‚ōĄ‰ņCƒVƒXƒvƒ‰ƒ`ƒ“‚Ė“Š—^Œã‚É–ō•Ļœ‹Ž–Ú“I‚É“§Í—Ö@‚ðs‚Ī‚ą‚Æ‚Ė—LŒøŦ‚ɂ‚Ē‚Ä•]‰ŋ‚ĩ‚―B

‰ð@ā

ƒVƒXƒvƒ‰ƒ`ƒ“‚ÍŒŒ’†‚É“ü‚é‚Æ‘Ž‚â‚Đ‚ÉŒŒŸũƒ^ƒ“ƒpƒN‚ÆŒ‹‡‚ĩCƒ^ƒ“ƒpƒN”ņŒ‹‡Œ^ƒVƒXƒvƒ‰ƒ`ƒ“ifree Ptj‚Đ‚įƒ^ƒ“ƒpƒNŒ‹‡Œ^ƒVƒXƒvƒ‰ƒ`ƒ“iātotal Ptj‚Æ‚Č‚éBƒVƒXƒvƒ‰ƒ`ƒ“‚Ė•›ė—p‚Æ‚ĩ‚Ä‚ĖtáŠQ‚ɂ‚Ē‚Ä‚Í“§ÍŠģŽŌ‚Ėę‡‚Í‚·‚łɐt‹@”\‚Í”pâ‚ĩ‚Ä‚Ē‚é‚―‚߁C‚Þ‚ĩ‚덜‘“ŐŦE––―_ŒoáŠQ‚Č‚Į‚Š–â‘č‚É‚Č‚é‚ƍl‚Ķ‚į‚ę‚éB

“§ÍŠģŽŌ‚ɃVƒXƒvƒ‰ƒ`ƒ“‚ð“Š—^‚ĩ–ō•Ļ“Ū‘Ô‚ðŒn““I‚É’ē‚Ũ‚―ŒĪ‹†‚́CĮ—á•ņˆČŠO‚É‚Í‚Ų‚Æ‚ņ‚Į‚Č‚ĒB‹{ė‚į‚͈ێ“§Í’†‚Ɉ݂Š‚ņ‚𔭏Į‚ĩ‚―5 —á‚ɃVƒXƒvƒ‰ƒ`ƒ“‚ð“Š—^‚ĩC–ō•Ļ“Ū‘Ô‚ð’ē‚Ũ‚―Œ‹‰Ę‚ð•ņ‚ĩ‚Ä‚Ē‚éB“§ÍŠJŽn‚Æ“ŊŽž“Š—^‚ĩ‚―ę‡‚Å‚Ífree Pt ‚ĖŒŒ’†”Z“x‚Í‹}‘Ž‚ɒቚ‚ĩCƒ_ƒCƒAƒ‰ƒCƒU[Œã‚ĖŒŒ’†”Z“x‚Í‘Š’čŠī“xˆČ‰š‚Æ‚Č‚čCtotal Pt ‚ĖŒŒ’†”Z“x‚ā‰Šú‚É”äŠr“I‹}s‚Č•Ï‰ŧ‚ðŽĶ‚ĩ‚―Œã‚ä‚é‚â‚Ђɉš~C“Š—^Œã1 ŽžŠÔ‚Å“§ÍŠJŽn‚ĩ‚―ę‡‚Å‚āfree Pt ‚Ļ‚æ‚Ņtotal Pt ‚ĖŒŒ’†”Z“x‚ÍŠî–{“I‚É“§ÍŠJŽn‚Æ“ŊŽž“Š—^‚ĩ‚―ę‡‚Æ“Ŋ—l‚Ė“Ū‚Ŧ‚ðŽĶ‚ĩ‚―C‚Æ‚ĩ‚Ä‚Ē‚é‚ŠC5 —á‚Ė‚Ī‚ŋ‚Į‚ĖĮ—á‚Å“§ÍŠJŽn‚Æ“ŊŽž“Š—^‚ĩC‚Į‚ĖĮ—á‚Å“Š—^Œã1 ŽžŠÔ‚Å“§ÍŠJŽn‚ĩ‚―‚Đ‚Í–ū‹L‚ģ‚ę‚Ä‚Ē‚Č‚Ē1jB‚Ü‚―C‹{ė‚į‚Í“Ŋ”N‚Ɉێ“§ÍŠģŽŌ‚ĖˆÝ‚Š‚ņĮ—á2 —á‚É‚Ļ‚Ŋ‚éƒVƒXƒvƒ‰ƒ`ƒ“‚Ė–ō•Ļ“Ū‘Ô‚Ė•ņ‚ðs‚Á‚Ä‚Ē‚é‚ŠC“ŊˆęĮ—á‚Đ‚Į‚Ī‚Đ‚Í•s–ū‚Å‚ ‚é2jB

Į—á•ņ‚ł́Cukey drug ‚ĖƒVƒXƒvƒ‰ƒ`ƒ“‚ĖŒø‰Ę‚ðÅ‘åŒĀ‚É“ū‚é‚―‚ß‚É‚ ‚Ķ‚Ä“Š—^—‚“ú‚Ė“§Í‚Æ‚ĩ‚―v‚Æ‚·‚é’–’Ü‚į‚Ė•ņ3jˆČŠO‚́C‚·‚Ũ‚ăVƒXƒvƒ‰ƒ`ƒ“‚ð“Š—^‚ĩ‚Ä30 •Š‚Đ‚į1 ŽžŠÔŒã‚É“§Í‚ðŠJŽn‚ĩ‚Ä‚Ē‚éB‚ą‚ę‚́CƒVƒXƒvƒ‰ƒ`ƒ“‚ð“Š—^‚ĩ‚Ä‚Đ‚įˆę’莞ŠÔ‚ð‚Ļ‚Đ‚Č‚Ē‚Æfree Pt ‚ŠŒŒŸũƒ^ƒ“ƒpƒN‚ÆŒ‹‡‚·‚é‘O‚É“§Í‚ģ‚ęŒŒ’†‚Đ‚įÁŽļ‚ĩ‚Ä‚ĩ‚Ü‚ĒC—LŒø‚ȍRŽîᇌø‰Ę‚Š“ū‚į‚ę‚Č‚­‚Č‚é‚―‚ß‚Å‚ ‚éBƒVƒXƒvƒ‰ƒ`ƒ“‚ð“Š—^‚·‚é‚Ɛt‹@”\ģíŽŌ‚Å‚Í‘Šú‚ÉŒŒ’†”Z“x‚Š‹}Œļ‚ĩiƒŋ‘ŠjC‚ŧ‚ĖŒã‚͊ɏ™‚ÉŒļ­‚·‚éiƒĀ‘Šj‚Æ‚Ē‚Ī“ņ‘ŠŦƒpƒ^[ƒ“‚ðŽĶ‚·B‚ą‚Ėƒpƒ^[ƒ“‚Í–Ŧt•s‘SŠģŽŌ‚Å‚ā‚Ý‚į‚ęCƒŋ‘Š‚̓VƒXƒvƒ‰ƒ`ƒ“‚Ė‘gD‚Ö‚ĖˆÚs‚É‚æ‚é‚ā‚Ė‚Å‚ ‚é‚ƍl‚Ķ‚į‚ę‚Ä‚Ē‚é4jBƒĀ‘Š‚͐t‘Ÿ‚Đ‚į‚Ė”rŸ•‚É‚æ‚é‚ā‚Ė‚ŁCt•s‘SŠģŽŌ‚Å‚Í‚ą‚ĖŒļ­‚Šˆę‘w­‚Č‚Ē‚ЁC‚ ‚é‚Ē‚͏ÁŽļ‚ĩ‚Ä‚Ē‚éB“ņ‘ŠŦƒpƒ^[ƒ“‚́CƒVƒXƒvƒ‰ƒ`ƒ“‚ð“Š—^‚ĩ‚Ä30 •Š‚Đ‚į1 ŽžŠÔŒã‚É“§Í‚ðŠJŽn‚ĩ‚―•ņ‚Å‚ā”F‚ß‚į‚ę‚Ä‚Ē‚éB

ķ‘Ė“ā‚É“Š—^‚ģ‚ę‚―ƒVƒXƒvƒ‰ƒ`ƒ“‚Í’ZŽžŠÔ‚Ė‚Ī‚ŋ‚ÉŒŒŸũ‚Ļ‚æ‚Ņ‘gD’†ƒ^ƒ“ƒpƒN‚ÆŒ‹‡‚ĩ“§Í‚ģ‚ę‚Č‚­‚Č‚é‚―‚߁C–ņ3.5`4 ŽžŠÔ‚Ė“§Í‚Å10“‘OŒã‚Šœ‹Ž‚ģ‚ę‚é‚É‚·‚Ž‚Č‚Ē5, 6jBœ‹Ž‚ģ‚ę‚éƒVƒXƒvƒ‰ƒ`ƒ“‚Ė‚Ų‚Æ‚ņ‚Į‚Ífree Pt ‚Å‚ ‚čC‘gD‚âƒ^ƒ“ƒpƒN‚ÉŒ‹‡‚ĩ‚Ä‚Ē‚éƒVƒXƒvƒ‰ƒ`ƒ“‚Ė‘å•”•Š‚Í“§Í‚ðs‚Á‚Ä‚ā‘Ė“ā‚ÉŽc‚éB“§ÍŒã‚̓ŠƒoƒEƒ“ƒh‚É‚æ‚čCŒŒ’†‚Ėfree Pt ‚͍ďãļ‚·‚é3, 8-12jB‚Ü‚―C—ݐσVƒXƒvƒ‰ƒ`ƒ“—Ę‚Š‘―‚­‚Č‚é‚ƁC“§Í‚É‚æ‚鏜‹Ž—Ķ‚Š‚ģ‚į‚ɒቚ‚·‚é‚Æ‚ģ‚ę‚Ä‚Ē‚é10, 13jB

ˆČã‚æ‚čCfree Pt ‚Í“§Í‚Å‚Ų‚Æ‚ņ‚Įœ‹Ž‰Â”\‚Å‚ ‚é‚ŠC‘gD‚âƒ^ƒ“ƒpƒN‚ÉŒ‹‡‚ĩ‚Ä‚Ē‚éƒVƒXƒvƒ‰ƒ`ƒ“‚Ė‘å•”•Š‚Í“§Í‚ðs‚Á‚Ä‚ā‘Ė“ā‚ÉŽc‚čC“§ÍŒã‚ɃŠƒoƒEƒ“ƒh‚É‚æ‚éÄãļ‚Š”F‚ß‚į‚ę‚é‚ƍl‚Ķ‚į‚ę‚éB‚ĩ‚―‚Š‚Á‚āC–{CQ ‚ɑ΂ĩ‚ẮCu“Š—^Œã‚É“§Í‚ðs‚Á‚Ä‚ā10“’ö“x‚ĩ‚Џœ‹Ž‚Å‚Ŧ‚Č‚Ē‚΂Ђč‚ЁCƒŠƒoƒEƒ“ƒhŒŧÛ‚Š‹N‚Ŧ‚é‚―‚߁C“Š—^Œã‚Ėƒ^ƒCƒ~ƒ“ƒOi’žŒãC30 •Š`1 ŽžŠÔŒãj‚ÉŠÖ‚í‚į‚ļCœ‹Ž–Ú“I‚Å‚Ė“§Í‚͐„§‚ģ‚ę‚Č‚Ēv‚ƍl‚Ķ‚į‚ę‚éB‚―‚ū‚ĩCĮ—á•ņ‚ÉŠî‚­ƒGƒLƒXƒp[ƒgƒIƒsƒjƒIƒ“‚Å‚ ‚čCƒGƒrƒfƒ“ƒX\f—ÃMƒƒƒbƒv‚ð‰ðÁ‚·‚é‚―‚߂ɍĄŒã‚ģ‚į‚Č‚é—Տ°ŒĪ‹†‚Š•K—v‚Č—Ėˆæ‚Å‚ ‚éB‚Č‚ĻC“§ÍŠģŽŌ‚Å‚ĖƒVƒXƒvƒ‰ƒ`ƒ“Žg—p‚É‚Ļ‚Ē‚Ä‚Í50`75“‚ĖŒļ—Ę‚Š„§‚ģ‚ę‚Ä‚Ļ‚č14, 15jC“Š—^Œã‚É“§Í‚ðŽ{s‚ĩ‚―ę‡‚āƒVƒXƒvƒ‰ƒ`ƒ“‚Ė’~Ï‚É‚Í’ˆÓ‚·‚é•K—v‚Š‚ ‚éB

yŽQl•ķŒĢz

1j ‹{ė­š‚Ų‚ЁD–Ŧt•s‘SˆÛŽ“§ÍŠģŽŌ‚É‚Ļ‚Ŋ‚écis-diamminedichloroplatinumiCDDPj‚Ė‘Ė“ā“Ū‘ԁDŠā‚ƉŧŠw—Ö@D1987G14F2491-5D

2j ‹{ė­š‚Ų‚ЁDˆÛŽ“§ÍŠģŽŌ‚ɍ‡•đ‚ĩ‚―ˆÝŠā‚ɑ΂·‚éCisplatinum ‚ðŽå‘Ė‚Æ‚ĩ‚―‰ŧŠw—Ö@‚ĖŒŸ“ĒDt‚Æ“§ÍD1987G23F179-82D

3j ’–’Ü—ēŽj‚Ų‚ЁDisŠúƒƒ‰ƒm[ƒ}‚ð‡•đ‚ĩ‚―lH“§ÍŠģŽŌ‚ÉDAC-Tam —Ö@‚ðŽ{s‚ĩ‚―1 —áDSkin CancerD2005G20F93-8D

4j z–K‘―‡“ņ‚Ų‚ЁD–Ŧt•s‘SŠģŽŌ‚É‚Ļ‚Ŋ‚éCDDP ‚ĖŒŒ’†“Ū‘ԁDŠā‚ƉŧŠw—Ö@D1988G15F243-8D

5j Gouyette A, et al. Kinetics of cisplatin in an anuric patient undergoing hemofiltration dialysis. Cancer Treat Rep. 1981G65F665-8. PMIDF7195773

6j ‰Ą–؍LK‚Ų‚ЁD–Ŧt•s‘S‚ð‡•đ‚ĩ‚―”AŠĮŠāĮ—á‚ɑ΂·‚éMethotrexateCVinblastineCAdriamycinCCis-platinum •đ—p—Ö@‚ĖŒoŒąDŠā‚ƉŧŠw—Ö@D1993G20F2405-7D

7j ī…–ƒˆß‚Ų‚ЁD–Ŧt•s‘S‚ð—L‚·‚éisãŠāŠģŽŌ‚ɑ΂·‚éó‘Ī“Š“Ū–Ž‚ƌ㓊“Ū–Ž‚æ‚č‚Ė’ī‘I‘ð“I“Ū’–@‚ð—p‚Ē‚―˜A“ú“ŊŽž•úŽËü‰ŧŠw—Ö@‚ĖŒoŒą\ŒŒ’†ƒvƒ‰ƒ`ƒi‚Ė‘Ė“ā“Ū‘Ô‚ĖŒŸ“ĒD“ú–{ŒûoŽîᇊw‰ïŽD2010G22F45-51D

8j Vˆä—zŽq‚Ų‚ЁDŒŒ‰t“§Í’†‚Ė–Ŧt•s‘SŠģŽŌ‚ɍ‡•đ‚ĩ‚―isH“đŠā‚ɑ΂ĩ‚Ä5-Fluorouracil{cis-dichlorodiammineplatinum{•úŽËüÆŽË“ŊŽž•đ—p—Ö@‚Š—LŒø‚Å‚ ‚Á‚―1 —áD“ú–{Á‰ŧŠí•aŠw‰ïŽGŽD2008G105F1482-8D

9j —é–Ø‹M”Ž‚Ų‚ЁD“§Í’†‚ĖãŠ{Šā—á‚ɑ΂·‚é‘I‘ð“I“Ū’‰ŧŠw—Ö@‚ĖŒoŒąDŽĻ•@ˆôA‰Č—Տ°D2006G99F439-44D

10j “ŋ‰im‚Ų‚ЁD–Ŧt•s‘S‚𔚂Á‚―”A˜Hã”įŽîᇂɑ΂·‚錌‰t“§Í•đ—pM-VAC —Ö@Žž‚Ė–ō•Ļ‘Ė“ā“Ū‘ԁDŠā‚ƉŧŠw—Ö@D2000G27F2079-85D

11j ē“Ą–LŽĀ‚Ų‚ЁDˆÛŽŒŒ‰t“§Í’†‚ĖŽq‹{‘ĖŠāĮ—á‚É‚Ļ‚Ŋ‚錌’†Cisplatinum‚Ė”Z“x„ˆÚD“ú–{ŽY‰Č•wl‰ČŠw‰ïŽGŽD1996G48F303-6D

12j ˆŧ•”Œöœō‚Ų‚ЁD–Ŧt•s‘S“§ÍŠģŽŌ‚É‚Ļ‚Ŋ‚éCisplatiniCDDPj‚Ļ‚æ‚ŅVindesineiVDSj‚Ė‘Ė“ā“Ū‘Ô‚ÉŠÖ‚·‚錟“ĒDŠā‚ƉŧŠw—Ö@D1989G16F3283-5D

13j Œã“ĄL”V‚Ų‚ЁDŒŒ‰t“§ÍŠģŽŌ‚É‚Ļ‚Ŋ‚éCisplatiniCDDPj‹y‚ŅFluorouracili5-FUj‚Ė‘Ė“ā“Ū‘ԁDTDM ŒĪ‹†D1988G15F329-33D

14j Janus N, et al. Proposal for dosage adjustment and timing of chemotherapy in hemodialyzed patients. Ann Oncol. 2010G21F1395-403. PMIDF20118214

15j Lichtman SM, et al. International Society of Geriatric OncologyiSIOGjrecommendations for the adjustment of dosing in elderly cancer patients with renal insufficiency. Eur J Cancer. 2007G43F14-34. PMIDF17222747


i5j“ÁŽę‚ȍ‡•đĮ

CQ15

Žîᇕö‰óĮŒóŒQ‚Ė—\–h‚Ƀ‰ƒXƒuƒŠƒJ[ƒ[‚͐„§‚ģ‚ę‚é‚ЁH

Žîᇕö‰óĮŒóŒQ‚Ė—\–h‚Ƀ‰ƒXƒuƒŠƒJ[ƒ[‚͐„§‚ģ‚ę‚éB

„§ƒOƒŒ[ƒh
s‚Ī‚ą‚Æ‚ð‹­‚­„§‚·‚é
—v@–ņ

Žîᇕö‰óĮŒóŒQiTLSj—\–h‚Ė‚―‚ß‚Ėƒ‰ƒXƒuƒŠƒJ[ƒ[“Š—^‚Ė“K‰ž‚́C“ú–{—Տ°Žîᇊw‰ï‚É‚æ‚éTLS f—ÃKƒCƒ_ƒ“ƒX1j‚ÅŠeƒŠƒXƒN•Ę‚ɏq‚Ũ‚į‚ę‚Ä‚Ļ‚čCƒ‰ƒXƒuƒŠƒJ[ƒ[“Š—^‚É‚æ‚錌‰t“§Í“ą“ü‚ĖƒŠƒXƒN’ቚ‚ā•ņ‚ģ‚ę‚Ä‚Ē‚éBƒ‰ƒXƒuƒŠƒJ[ƒ[“Š—^‚Í”AŽ_’l‚ð’ቚ‚ģ‚đCtáŠQ—\–hė—p‚ðŽĶ‚ĩCTLS —\–h‚É—LŒø‚Å‚ ‚éB

”wŒiE–Ú“I

ƒ‰ƒXƒuƒŠƒJ[ƒ[‚͈â“`Žq‘gŠ·‚ĶŒ^”AŽ_ƒIƒLƒVƒ_[ƒ[‚Å‚ ‚čC”AŽ_‚ðƒAƒ‰ƒ“ƒgƒCƒ“‚É‘Ž‚â‚Đ‚É‘ãŽÓ‚·‚éB”AŽ_‚Æ”äŠr‚·‚é‚ƁCƒAƒ‰ƒ“ƒgƒCƒ“‚Ė”A’†—n‰ð“x‚Í‚Ŧ‚í‚߂č‚‚Ē‚―‚߁C‚ą‚Ė‘ãŽÓ‚É‚æ‚čŒŒ’†‚Ė”AŽ_”Z“x‚Í‹}‘Ž‚ɒቚ‚·‚éB“Š—^‚ɍۂĩ‚ẮC①y‘fŧÜ‚Å‚ ‚é‚―‚߁C‰ß•q”―‰ž‚ð‚Ŧ‚―‚·‰Â”\Ŧ‚Š‚ ‚é‚ą‚ƁC②R‘ĖŽYķ‚Ė•ņ‚Š‚ ‚čCÄ“Š—^‚Š”F‚ß‚į‚ę‚Ä‚Ē‚Č‚Ē‚ą‚ƁC③ƒOƒ‹ƒR[ƒX-6-ƒŠƒ“Ž_’E…‘fy‘fŒ‡‘đĮĮ—á‚Ö‚Ė“Š—^‚Í‹ÖŠõ‚Å‚ ‚é‚ą‚Æ‚Č‚Į‚É’ˆÓ‚Š•K—v‚Å‚ ‚éB–{e‚ł́CTLS ‚Ė—\–h‚Ƀ‰ƒXƒuƒŠƒJ[ƒ[‚Š„§‚ģ‚ę‚é‚ĐŒŸ“Ē‚ĩ‚―B

‰ð@ā

TLS —\–h‚Ė‚―‚ß‚Ėƒ‰ƒXƒuƒŠƒJ[ƒ[“Š—^‚Ė“K‰ž‚́CTLS f—ÃKƒCƒ_ƒ“ƒX1j‚ÅŠeƒŠƒXƒN•Ę‚ɏq‚Ũ‚į‚ę‚Ä‚Ļ‚čC①‚ƒŠƒXƒNĮ—áC②’†ŠÔƒŠƒXƒNĮ—á‚ŃAƒƒvƒŠƒm[ƒ‹CƒtƒFƒuƒLƒ\ƒXƒ^ƒbƒg‚É‚æ‚é—\–h‚É‚āŠÖ‚í‚į‚ļ”AŽ_’l‚ŠŽ‘ą“I‚ɏãļ‚·‚éę‡‚âCf’fŽž‚ɍ‚”AŽ_ŒŒĮ‚Š”F‚ß‚į‚ę‚éę‡‚ɑ΂ĩ‚Ä“Š—^C‚ ‚é‚Ē‚Í“Š—^‚ðl—ķ‚·‚é‚Æ‚ģ‚ę‚Ä‚Ē‚é1jBƒ‰ƒXƒuƒŠƒJ[ƒ[‚ĖTLS —\–hė—p‚ÉŠÖ‚ĩ‚ẮCTLS ‚ƒŠƒXƒNĮ—á‚ð‘ΏۂɁCƒ‰ƒXƒuƒŠƒJ[ƒ[’PÜi0.20 mg/kg/“úday 1`5j‚ƃ‰ƒXƒuƒŠƒJ[ƒ[‚ƃAƒƒvƒŠƒm[ƒ‹•đ—piƒ‰ƒXƒuƒŠƒJ[ƒ[0.20 mg/kg/“úday 1`3 ‚Ļ‚æ‚ŅƒAƒƒvƒŠƒm[ƒ‹300 mg/“úday 3`5jCƒAƒƒvƒŠƒm[ƒ‹’PÜi300 mg/“úday 1`5j‚Ƀ‰ƒ“ƒ_ƒ€Š„•t‚Ŋ‚ĩ‚―‘æⅢ‘ŠŽŽŒą‚É‚Ļ‚Ē‚āCƒ‰ƒXƒuƒŠƒJ[ƒ[’PÜ‚̓AƒƒvƒŠƒm[ƒ‹’PÜ‚Æ‚­‚į‚Ũ‚Ä—LˆÓ‚ÉLaboratory TLS*‚Ė•p“x‚ð’ቚ‚ģ‚đ‚é‚ą‚Æ‚ŠŽĶ‚ģ‚ę‚―2jB‚Ü‚―CŽŽ™‚ð‘ΏۂƂĩ‚―‚Ē‚­‚‚ЂĖŽŽŒą‚Å‚āCƒAƒƒvƒŠƒm[ƒ‹‚É”ä‚ĩƒ‰ƒXƒuƒŠƒJ[ƒ[‚Š—LˆÓ‚É”AŽ_’l‚ð’ቚ‚ģ‚đ‚é‚ą‚Æ‚ŠŽĶ‚ģ‚ę‚Ä‚Ē‚é3, 4jB‚Ü‚―ƒ‰ƒXƒuƒŠƒJ[ƒ[‚ĖtáŠQ—\–hė—p‚ÉŠÖ‚ĩ‚ẮC”’ŒŒ•a‚Ļ‚æ‚ŅƒŠƒ“ƒpŽî‚ð‘ΏۂƂĩ‚―•Ą”‚Ė—Տ°ŽŽŒą‚ĖƒVƒXƒeƒ}ƒeƒBƒbƒNƒŒƒrƒ…[‚É‚æ‚é‚ƁCƒ‰ƒXƒuƒŠƒJ[ƒ[‚ð•đ—p‚ĩ‚―ę‡‚ĖŒŒ‰t“§Í“ą“ü‚Ė•p“x‚Í0`2.8“C•đ—p‚ĩ‚Ä‚Ē‚Č‚Ēę‡‚Í15.9`25.0“‚Å‚ ‚čCƒ‰ƒXƒuƒŠƒJ[ƒ[Žg—p‚É‚æ‚čŒŒ‰t“§Í“ą“ü‚ĖƒŠƒXƒN‚Š’ቚ‚·‚éŒXŒü‚Š”F‚ß‚į‚ę‚―5jB‚ą‚Ė‚Ų‚ЁCTLS ‚ƒŠƒXƒNĮ—á‚É‚Ļ‚Ŋ‚郉ƒXƒuƒŠƒJ[ƒ[“Š—^‚É‚æ‚é”AŽ_’l‚Ė’ቚ‚́C‚Ē‚­‚‚ЂĖƒ‰ƒ“ƒ_ƒ€‰ŧ”äŠrŽŽŒą‚ÅŽĶ‚ģ‚ę‚Ä‚Ē‚é6, 7jBˆČãCƒ‰ƒXƒuƒŠƒJ[ƒ[“Š—^‚Í”AŽ_’l‚ð’ቚ‚ģ‚đCtáŠQ—\–hė—p‚ðŽĶ‚ĩCTLS —\–h‚É—LŒø‚Å‚ ‚é‚ƍl‚Ķ‚į‚ę‚éB

–Cairo-Bishop ‚Ėf’fŠî€‚É‚æ‚é8jB

yŽQl•ķŒĢz

1j “ú–{—Տ°Žîᇊw‰ïDŽîᇕö‰óĮŒóŒQiTLSjf—ÃKƒCƒ_ƒ“ƒXD ‹āŒīo”ŁC2013D

2j Cortes J, et al. Control of plasma uric acid in adults at risk for tumor Lysis syndromeFefficacy and safety of rasburicase alone and rasburicase followed by allopurinol compared with allopurinol alone--results of a multicenter phase Ⅲ study. J Clin Oncol. 2010G28F4207-13. PMIDF20713865

3j Goldman SC, et al. A randomized comparison between rasburicase and allopurinol in children with lymphoma or leukemia at high risk for tumor lysis. Blood. 2001G97F2998-3003. PMIDF11342423

4j Cheuk DK, et al. Urate oxidase for the prevention and treatment of tumour lysis syndrome in children with cancer. Cochrane Database Syst Rev. 2014G8FCD006945. PMIDF25121561

5j Jeha S, et al. Efficacy and safety of rasburicase, a recombinant urate oxidaseiElitekj, in the management of malignancy-associated hyperuricemia in pediatric and adult patientsFfinal results of a multicenter compassionate use trial. Leukemia. 2005G19F34-8. PMIDF15510203

6j Vadhan-Raj S, et al. A randomized trial of a single-dose rasburicase versus five-daily doses in patients at risk for tumor lysis syndrome. Ann Oncol. 2012G23F1640-5. PMIDF22015451

7j Kikuchi A, et al. A study of rasburicase for the management of hyperuricemia in pediatric patients with newly diagnosed hematologic malignancies at high risk for tumor lysis syndrome. Int J Hematol. 2009G90F492-500. PMIDF19701676

8j Cairo MS, et al. Tumour lysis syndromeFnew therapeutic strategies and classification. Br J Haematol. 2004G127F3-11. PMIDF15384972


CQ16

R‚Š‚ņ–ō‚É‚æ‚éTMA ‚ɑ΂ĩ‚ÄŒŒŸũŒðŠ·‚͐„§‚ģ‚ę‚é‚ЁH

R‚Š‚ņ–ō‚É‚æ‚éTMA ‚ɑ΂ĩC–ūŠm‚ČƒGƒrƒfƒ“ƒX‚Í‚Č‚Ē‚―‚߁CŒŧŽž“_‚ł͐„§‚ģ‚ę‚Č‚ĒBTMA ‚É‚æ‚étáŠQ‚ɑ΂·‚錌ŸũŒðŠ·‚́Ci“W‚ð—}§‚ĩ‚Ä‚Ē‚éĮ—á‚ŠŽUŒĐ‚ģ‚ę‚é‚ā‚Ė‚ĖC‚ŧ‚Ė—LŒøŦ‚ð•]‰ŋ‚·‚é‚Ü‚Å‚É‚ÍŽŠ‚į‚ļCŒŧŽž“_‚ł͐„§‚ģ‚ę‚Č‚ĒB

„§ƒOƒŒ[ƒh
s‚í‚Č‚Ē‚ą‚Æ‚ðŽã‚­„§‚·‚éi’ņˆÄ‚·‚éj
—v@–ņ

R‚Š‚ņ–ō‚É‚æ‚éTMA ‚ɑ΂·‚錌ŸũŒðŠ·‚Ė—LŒøŦ‚ɂ‚Ē‚ẮCM—Š‚Å‚Ŧ‚é‚ū‚Ŋ‚ĖƒGƒrƒfƒ“ƒX‚É–R‚ĩ‚­CŒŧó‚͐„§‚ģ‚ę‚Č‚ĒBƒ}ƒCƒgƒ}ƒCƒVƒ“C ‚ɂ‚Ē‚Ă̓P[ƒXƒVƒŠ[ƒY‚≥’fŒĪ‹†‚Å‚Ė•ņ‚Š‚Ē‚­‚‚Ђ ‚é‚ā‚Ė‚ĖCŒŒŸũŒðŠ·’P“Æ‚Å‚ĖŽĄ—Âɂæ‚é•]‰ŋ‚Í‚Č‚­CRŒŒŽ”–ō‚Ļ‚æ‚ŅƒXƒeƒƒCƒh‚É‚æ‚é–ō•Ļ—Ö@‚⌌ŸũŒðŠ·Œã‚ÉŒŒ‰t“§Í‚ð•đ—p‚ĩ‚Ä‚Ē‚é—á‚ā‘―‚ĒBˆę•ûCTMA ‚É‚æ‚étáŠQ‚ɂ‚Ē‚ẮCŒŒŸũŒðŠ·‚É‚æ‚čt‹@”\‚Ė‚ģ‚į‚Č‚é‘ˆŦ‚ð—}§‚·‚é’ö“x‚É‚Æ‚Į‚Ü‚Á‚―‚Æ‚·‚éĮ—á•ņ‚Š‘―‚­CŒŒ‰t“§Í‚Ė•đ—p‚Č‚Į‚ā‚ ‚čŒŒŸũŒðŠ·‚Ė—L—pŦ‚ð•]‰ŋ‚·‚é‚Ü‚Å‚É‚ÍŽŠ‚į‚Č‚ĒB

”wŒiE–Ú“I

TMA ‚ÍŒŒŽ”ÂŒļ­C”ũŽŒŒŠĮĮŦ—nŒŒŦ•nŒŒC‘ŸŠíáŠQ‚ĖŽO‚‚ð’æ‚·‚éŽūŠģ‚Å‚ ‚éB“TŒ^“I‚ČTMA ‚Ía disintegrin-like and metalloproteinase with thrombospondin type 1 motifs 13iADAMTS13jŠˆŦ‚ŠŒļ­‚·‚錌ðŦŒŒŽ”ÂŒļ­ŦŽ‡”Á•aiTTPj‚Ļ‚æ‚ŅŽu‰ę“Å‘f‚É‚æ‚é—nŒŒŦ”A“ŏĮĮŒóŒQiHUSj‚Å‚ ‚éBˆę•û‚ŁCTMA ‚Ė•a‘Ô‚Í–Ē‰ð–ū‚Č•”•Š‚ā‘―‚­C‘―Ę‚Č•a‘Ô‚ð’æ‚·‚é‚―‚߁C2013 ”N‚ÉTTP ‚ÆHUS ˆČŠO‚ĖTMA ‚ð”ņ“TŒ^—nŒŒŦ”A“ŏĮĮŒóŒQiaHUSj‚Æ’č‹`‚ĩf’fŠî€‚ŠėŽ‚ģ‚ę‚Ä‚Ē‚é1jBTTP ‚͐æ“VŦ‚Ļ‚æ‚ŅŒã“VŦ‚ÉADAMTS13 ŠˆŦ‚Š’ቚ‚·‚é‚ŠC‚ŧ‚Ė‘―‚­‚ÍŒã“VŦ‚Å‚ ‚čCADAMTS13 ‚ɑ΂·‚éŽĐŒČR‘Ė‚ŠŠÖ—^‚ĩ‚Ä‚Ē‚éB‚ŧ‚Ė‚―‚ߌã“VŦTTP ‚ɑ΂ĩ‚Ä‚ÍŒŒŸũŒðŠ·‚Š‘æˆę‘I‘ð‚Æ‚ģ‚ęCADAMTS13 •â[CADAMTS13 ‘jŠQR‘Ė‚Ėœ‹Ž‚âŽ~ŒŒˆöŽq‚Å‚ ‚évon Willebrand factorivWFj‚Ė‘―—Ę‘Ė‚Å‚ ‚é’ī‚•ŠŽq—ĘVWF ‘―d‘ĖiUL-VWFMj‚Ėœ‹Ž‚ð–Ú“I‚Æ‚ĩ‚Ä‚Ē‚éB‚Ü‚―HUS ‚ɑ΂ĩ‚ẮCŒŒŸũŒðŠ·‚Ė—LŒøŦ‚ÍŠm—§‚ĩ‚Ä‚Ļ‚į‚ļCŽxŽ—Ö@‚ŠŽå‘Ė‚Å‚ ‚éBaHUS ‚É‚Ļ‚Ē‚Ä‚ā•â‘ĖŒnˆŲí‚É‚æ‚éaHUS ‚ɑ΂ĩ‚ÄŒŒŸũŒðŠ·‚Šs‚í‚ę‚é‚ŠC‚ŧ‚Ė•aˆö‚Š‘―Ę‚Å‚ ‚é‚―‚ß—LŒøŦ‚ÍŠm—§‚ĩ‚Ä‚Ē‚Č‚ĒB–ō•Ļ—U”­ŦTMA ‚ɂ́Cƒ`ƒNƒƒsƒWƒ“‚Č‚Į‚ĖRŒŒŽ”–ō‚É‚Ļ‚Ŋ‚éADAMTS13 ‚ɑ΂·‚é–ƉuŠw“IŽĐŒČR‘ĖŽYķ‚É‚æ‚éTTP ‚Š‚ ‚čC‚ą‚Ėę‡‚É‚ÍŒŒŸũŒðŠ·‚Š—LŒø‚Å‚ ‚éBˆę•ûCƒVƒNƒƒXƒ|ƒŠƒ“‚âƒ^ƒNƒƒŠƒ€ƒX‚Č‚Į‚ĖƒJƒ‹ƒVƒjƒ…[ƒŠƒ“‘jŠQ–ō‚ÍADAMTS13 ŠˆŦ’ቚ‚Š­‚Č‚­CŒŒŠĮ“ā”įáŠQ‚Č‚Į‚ŠŽå‘Ė‚Å‚ ‚éaHUS ‚Æ‚ģ‚ęCŒŒŸũŒðŠ·‚Š—LŒø‚Å‚Č‚Ē‚ą‚Æ‚Š‘―‚ĒB–ōÜ—U”­ŦTMA ‚Ė‘―‚­‚ŠaHUS ‚É—ÞŽ—‚ĩ‚―•a‘Ô‚ð’æ‚·‚é‚ÆŽv‚í‚ę‚é‚ŠC‚ŧ‚Ė‹@˜‚ðŠÜ‚ß‚Ä•s–ū‚Č“_‚Š‘―‚ĒB–ōÜ—U”­ŦTMA ‚ĖŒīˆö‚Æ‚Č‚éR‚Š‚ņ–ō‚Æ‚ĩ‚āCƒ}ƒCƒgƒ}ƒCƒVƒ“CCƒVƒXƒvƒ‰ƒ`ƒ“CƒuƒŒƒIƒ}ƒCƒVƒ“CƒQƒ€ƒVƒ^ƒrƒ“Cƒyƒ“ƒgƒXƒ^ƒ`ƒ“CƒXƒjƒ`ƒjƒu‚Č‚Į‚Š‚ ‚°‚į‚ę‚Ä‚Ē‚é2jB

TMA ‚ɑ΂ĩ‚čRŒŒŽ”–ō‚âƒXƒeƒƒCƒh‚Ė“Š—^‚Ļ‚æ‚ŅŒŒŸũŒðŠ·‚Šs‚í‚ę‚Ä‚Ē‚é‚ŠCŠm—§‚ģ‚ę‚―ŽĄ—Ö@‚Í‚Č‚ĒB–{e‚ł́CR‚Š‚ņ–ō‚É‚æ‚éTMA ‚ɑ΂·‚錌ŸũŒðŠ·‚Ė—LŒøŦ‚ɂ‚Ē‚ÄŒŸØ‚ĩ‚―B

‰ð@ā

ƒ}ƒCƒgƒ}ƒCƒVƒ“C ‚É‚æ‚éTMA‚ɑ΂·‚錌ŸũŒðŠ·‚Ė—LŒøŦ‚ɂ‚Ē‚ẮC4 —á‚ĖƒP[ƒXƒVƒŠ[ƒY‚Å3jCRŒŒŽ”–ō{ŒŒŸũŒðŠ·i3`4 Lj‚ð1`2 TŠÔ‚Å5`7 ‰ņs‚Á‚―Œ‹‰Ę‚Š•ņ‚ģ‚ę‚Ä‚Ē‚éB‚ą‚Ė‚Ī‚ŋ2 —á‚ÍŒŒŽ””‚âÔŒŒ‹…”‚Č‚Į‚ĖŒŒ‰tŠw“Iƒpƒ‰ƒ[ƒ^[‚Í‘Ž‚â‚Ђɉü‘P‚ĩCt‹@”\‚ā6 TŠÔˆČ“ā‚ɉņ•œŒXŒü‚É‚ ‚Á‚―B1 —á‚ÍŒŒŸũŒðŠ·Ž{sŒã‚ɐt‹@”\’ቚ‚ÍŒp‘ą‚ĩ‚―‚ā‚Ė‚ĖC‚ŧ‚ĖŒã4 ƒ•ŒŽˆČã‚Đ‚Ŋ‚ÄŠÉ‚â‚Ђȉņ•œ‚ðŽĶ‚ĩ‚―BÅŒã‚Ė1 —á‚ł́CŒŒŸũŒðŠ·Ž{sŒã‚ÉŒŒŽ””‚Í‘‰Á‚ĩ‚―‚ā‚Ė‚ĖCt‹@”\‚Ė‰ü‘P‚Í“ū‚į‚ę‚Ę‚Ü‚ÜŽ€–S‚ĩ‚―B‚ą‚ę‚į‚ĖĮ—á‚ł́Cƒ}ƒCƒgƒ}ƒCƒVƒ“C ‚Ė‘“Š—^—ʂɂ‚Ē‚āCTMA ‚Ė”­Į‚Æ‚ĖŠÖ˜AŦ‚Í‚Ý‚į‚ę‚ļCŒŒŸũŒðŠ·‚Ė—L—pŦ‚ɂ‚Ē‚Ä‚ā–ūŠm‚ČŒ‹˜_‚ð”F‚ß‚Č‚Đ‚Á‚―Bˆę•”‚ĖĮ—á‚ł́CŒŒŸũŒðŠ·’P“Æ‚Å‚Í‚Č‚­RŒŒŽ”–ōiƒWƒsƒŠƒ_ƒ‚[ƒ‹CƒXƒ‹ƒtƒBƒ“ƒsƒ‰ƒ]ƒ“‚Č‚Įj‚⌌‰t“§Í—Ö@iðŒ•s–ūj‚ð•đ—p‚ĩ‚Ä‚Ē‚é‚―‚߁CŒŒŸũŒðŠ·’P“Æ‚Å‚ĖŒø‰Ę‚Í•]‰ŋ‚Š“ï‚ĩ‚ĒB

‚Ü‚―C‚Š‚ņŠÖ˜A—nŒŒŦ”A“ŏĮĮŒóŒQiCancer-associated HUSj‚Æ‚ĩ‚āCƒwƒ}ƒgƒNƒŠƒbƒg…25“CŒŒŽ””ƒ10~104ƒĘLCŒŒīCr†1.6 mg/dL ‚ĖŠģŽŌiƒ}ƒCƒgƒ}ƒCƒVƒ“C “Š—^ŠģŽŌ‚Ė99“C5-FU “Š—^ŠģŽŌ‚Ė68“‚ŠŠY“–j‚ð‘ΏۂƂĩ‚―‰Ą’fŒĪ‹†‚É‚Ļ‚Ē‚Ä4jCŒŒŸũŒðŠ·‚ðŽ{s‚ĩ‚―37 —á‚Ė‚Ī‚ŋCŽĄ—ÑtŒø—á‚Í11 —ái30“j‚ŁC–ģŒø‚ā‚ĩ‚­‚Í‘ˆŦ—á‚Í26 —ái70“j‚Å‚ ‚Á‚―B‚ģ‚į‚ɁC12 —á‚Ėƒ}ƒCƒgƒ}ƒCƒVƒ“C ‚ðŠÜ‚Þ‰ŧŠw—Ö@ƒŒƒWƒƒ“‚É‚æ‚čTMA ‚𔭏Į‚ĩ‚―ƒP[ƒXƒVƒŠ[ƒY‚É‚Ļ‚Ē‚Ä‚Í5jC‘S—á‚Šf’fŽž‚ɐt•s‘S‚Å‚ ‚čC2 —á‚ÍŒŒīCr ‚Š‚ŧ‚ę‚ž‚ę1.8 mg/dLC2.7 mg/dL ‚Å‚ ‚Á‚―‚ŠCŽc‚č‚Ė10 —á‚Í3.4`9.6 mg/dL‚Å‚ ‚Á‚―B‚ą‚ę‚į‚ĖŠģŽŌ‚Ė‚Ī‚ŋ6 —á‚ŠT3 ‰ņ‚Ė2 L ‚ĖŒŒŸũŒðŠ·‚ð1`2 TŠÔŽ{s‚ģ‚ęCRŒŒŽ”–ō‚âƒXƒeƒƒCƒh‚Ė•đ—p‚ðŽó‚Ŋ‚Ä‚Ē‚―B‚ĩ‚Đ‚ĩCŒŒŸũŒðŠ·‚É”―‰ž‚ĩ‚―‚Ė‚Í1 —á‚Ė‚݂ŁC‚ą‚ĖĮ—á‚̓XƒeƒƒCƒhCƒAƒUƒ`ƒIƒvƒŠƒ“CƒWƒsƒŠƒ_ƒ‚[ƒ‹‚Ė•đ—p‚Š‚ ‚Á‚―B

“û‚Š‚ņŠģŽŌ‚ł́CƒVƒNƒƒzƒXƒtƒ@ƒ~ƒhCƒVƒXƒvƒ‰ƒ`ƒ“‚Ļ‚æ‚ŅƒJƒ‹ƒ€ƒXƒ`ƒ“‚Ė3 Ü‚É‚æ‚é‘å—ʉŧŠw—Ö@{ŽĐŒČŒŒœ‘ŠēŨ–EˆÚAŒã‚ĖTMA ‚ɑ΂ĩ‚āCŒŒŸũŒðŠ·‚ð2`49 ‰ņi’†‰›’l46 ‰ņjŽ{s‚ĩ‚―‰Ą’fŒĪ‹†‚Šs‚í‚ę‚Ä‚Ē‚é6jB‘å—ʉŧŠw—Ö@‚Šs‚í‚ę‚―581 —á‚Ė‚Ī‚ŋCTMA ‚𔭏Į‚ĩ‚―‚Ė‚Í15 —ái2.6“j‚Å‚ ‚čCķ‘ķ‚ĩ‚―ŠģŽŌ‚Í4 —á‚Å‚ ‚Á‚―BTMA ‚𔭏Į‚ĩ‚―15 —á‚Ė‚Ī‚ŋC12 —á‚ɃXƒeƒƒCƒh—Ö@{ŒŒŸũŒðŠ·‚ŠŽ{s‚ģ‚ę‚―‚ŠCTMA f’fŒã‚Ėķ‘ķŠúŠÔ‚Í2`76 “úi’†‰›’l41 “új‚Å‚ ‚čCķ‘ķ‚ĩ‚―3 —á‚Å‚Í•―‹Ï50 ‰ņ‚ĖŒŒŸũŒðŠ·‚Šs‚í‚ę‚Ä‚Ē‚―B

ƒQƒ€ƒVƒ^ƒrƒ““Š—^2,586 —á’†TMA ‚Š”­Į‚ĩ‚―9 —á‚ĖƒP[ƒXƒVƒŠ[ƒY7j‚ł́C“Š—^Œã8 ƒ•ŒŽi3`18 ƒ•ŒŽjC‘“Š—^—Ę‚Í19.2 g/m2i9`56 g/m2j‚ÅTMA ‚ɐis‚ĩ‚―B‚ą‚Ė‚Ī‚ŋ6 —á‚͐ķ‘ķ‚ĩ‚―‚ŠC3 —á‚ÍŽ€–S‚ĩ‚Ä‚Ē‚éB‚ą‚Ė9 —á’†CŒŒŸũŒðŠ·‚ðs‚Á‚―‚Ė‚Í5 —á‚Å‚ ‚čC2 —á‚ÍŽ€–SC3 —á‚Í–Ŧt•s‘S‚Æ‚Č‚čC‚ŧ‚Ė‚Ī‚ŋ2 —á‚ÍŒŒ‰t“§Í‚Š•K—v‚Å‚ ‚Á‚―B‚ą‚Ė•ņ‚É‚Ļ‚Ē‚āCt‹@”\‚Š‰ņ•œ‚ĩ‚―3 —á‚Í‚Ē‚ļ‚ę‚āŒŒŸũŒðŠ·‚ðs‚Á‚Ä‚Ļ‚į‚ļC‚ą‚ĖÚŨ‚ɂ‚Ē‚Ä‚Í•s–ū‚Å‚ ‚éB

yŽQl•ķŒĢz

1j ”üË“ņ‚Ų‚ЁC”ņ“TŒ^—nŒŒŦ”A“ŏĮĮŒóŒQf’fŠî€ėŽˆÏˆõ‰ïD”ņ“TŒ^—nŒŒŦ”A“ŏĮĮŒóŒQ@f’fŠî€D“ú–{t‘ŸŠw‰ïŽD2013G55F91-3D

2j žˆäŸb‚Ų‚ЁD–ōÜŦ‚Ļ‚æ‚ŅˆÚAŠÖ˜AaHUSD“ú–{t‘ŸŠw‰ïŽD2014G56F1067-74D

3j Chow S, et al. Plasmapheresis and antiplatelet agents in the treatment of the hemolytic uremic syndrome secondary to mitomycin. Am J Kidney Dis. 1986G7F407-12. PMIDF3085480

4j Lesesne JB, et al. Cancer-associated hemolytic-uremic syndromeF analysis of 85 cases from a national registry. J Clin Oncol. 1989G7F781-9. PMIDF2497229

5j Cantrell JE Jr, et al. Carcinoma-associated hemolytic-uremic syndromeF a complication of mitomycin C chemotherapy. J Clin Oncol. 1985G3F723-34. PMIDF3923162

6j Fisher DC, et al. Thrombotic microangiopathy as a complication of high-dose chemotherapy for breast cancer. Bone Marrow Transplant. 1996G18F193-8. PMIDF8832014

7j Humphreys BD, et al. Gemcitabine-associated thrombotic microangiopathy. Cancer. 2004G100F2664-70. PMIDF15197810