在波兰血液透析患者中明显抗性高血压:流行率和危险因素
Bartosz Symonides1, Jacek Lewandowski1, Wojciech Marcinkowski2
1Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, 02-091 Warsaw, Poland.
Journal of clinical medicine
|August 26, 2023
概括
在接受血液透析的末期病 (ESKD) 患者中,大约40%的患者有明显的耐治疗高血压 (aTRH). 这种情况是多因素的,主要受到患者特征的影响,而不是透析因素.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 心脏病学 心脏病学
- 高血压研究 高血压研究
背景情况:
- 高血压是患有末期脏病 (ESKD) 的患者常见的并发症.
- 显而易见的耐治疗高血压 (aTRH) 在这个人群中是一个重要的临床挑战.
- 了解aTRH决定因素对于血液透析 (HD) 患者的有效管理至关重要.
研究的目的:
- 为了确定aTRH的患病率,特征和风险因素.
- 在一大批未经选择的ESKD患者中研究aTRH,这些患者接受维护血液透析.
- 要区分影响aTRH的患者相关和透析相关因素.
主要方法:
- 一个国家提供者的5879名血液透析患者的回顾性分析.
- 高血压和aTRH的定义是使用透析前和/或透析后血压测量.
- 患者特征与aTRH患者和无TRH患者之间的比较.
主要成果:
- 高血压的患病率很高 (90.7%在透析前,89.1%在透析后).
- aTRH发生率很大 (40.9%的透析前,38.4%的透析后).
- 与aTRH相关的因素包括年轻的年龄,心血管疾病史,糖尿病,更高的eKt/V,更大的超,以及更高的血压/心率.
结论:
- 近40%的血液透析患者在现实环境中表现出aTRH.
- ESKD患者的aTRH是多因素的,与患者相关的因素更有影响力.
- 在aTRH定义中的差异阻碍了跨研究的比较.
相关概念视频
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
26
Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
26
01:18Hypertension and Regulation of Blood Pressure
2.1K
Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
2.1K
01:28Hypertension I: Introduction
16
Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
16
01:29Hypertension II: Pathophysiology
15
Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
15
01:28Factors affecting Blood pressure
3.3K
Several physiological and lifestyle factors influence blood pressure (BP). Understanding these factors is crucial as they are significant in patient education and blood pressure management.
Physiological Factors:
Physiological Factors:
3.3K
01:24Hemodialysis II: Procedure and Complications
42
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
42