流行病学,病理生理学和临床视角的内射分析高血压
Panagiotis Theofilis1, Aikaterini Vordoni1, Rigas G Kalaitzidis1
1Center for Nephrology "G. Papadakis", General Hospital of Nikaia-Piraeus "Ag. Panteleimon", Nikaia, Greece.
American journal of nephrology
|May 26, 2023
概括
内透析性高血压 (IDHYPER) 是15%的血液透析患者出现的并发症,在治疗期间血压发生矛盾的升高. 管理重点是流体管理和非透析抗高血压药物.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心血管医学 心血管医学
背景情况:
- 慢性血液透析 (HD) 患者经常出现并发症,包括内透析性高血压 (IDHYPER).
- 虽然血压 (BP) 通常在HD后下降,但有些患者在HD期间矛盾地经历了高血压.
研究的目的:
- 审查当前关于日内分析高血压 (IDHYPER) 的证据.
- 讨论IDHYPER的拟议定义,病理生理学,临床影响和治疗选择.
主要方法:
- 现有关于日内透析性高血压 (IDHYPER) 的文献的综述.
- 对拟议的定义和病理生理机制的分析.
- 评估临床影响和管理策略.
主要成果:
- IDHYPER影响大约15%的HD患者,定义各不相同,但往往涉及显著的血压升高.
- 关键的病理生理因素包括流体过载,内皮功能障碍和交感神经系统激活.
- IDHYPER与不良心血管事件和死亡率有关,尽管其与透析间门诊BP的关联仍在争论中.
结论:
- 为了有效地管理IDHYPER,需要仔细评估细胞外液体体积和限制.
- 非透析的抗高血压药物有已证明的好处是最好的.
- 调整HD设置以减少干重,并考虑低透析剂或异热HD可能是有益的.
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