在血液透析中使用α-阻塞剂:日本透析结果和实践模式研究
Ken Iseri1, Chisato Miyakoshi2, Nobuhiko Joki3
1Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.
Kidney medicine
|September 4, 2023
概括
在接受血液透析的患者中使用α-阻断剂 (α-阻断剂) 没有增加骨折,跌倒或死亡的风险. 这表明阿尔法阻断剂在这种人群中对血压管理是安全的.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 阿尔法阻断剂用于高血压,但它们在血液透析患者中的安全性尚未得到充分证实.
- 关于阿尔法阻断剂使用与这种特定患者群体的不良结果之间的关联存在有限的数据.
研究的目的:
- 在接受血液透析的患者中研究α阻断剂抗高血压剂的安全性.
- 评估使用α阻断剂与骨折,跌倒和全因死亡风险之间的关联.
主要方法:
- 一项前性队列研究分析了来自日本透析结果和实践模式研究的5149名患者 (阶段4-6).
- 主要暴露是阿尔法阻断抗高血压药物的基线处方.
- 用多变量Cox和修改的Poisson回归分析来评估结果.
主要成果:
- 在使用α阻断剂和骨折风险增加 (HR,0.92),跌倒 (HR,0.94) 或全因死亡率 (HR,0.87) 之间没有发现显著的关联.
- 亚组分析表明,在老年患者,女性,有心血管疾病病史或高血压前透析患者中,使用α抑制剂降低了全因死亡风险.
结论:
- 在血液透析患者中使用α-阻断剂与骨折,跌倒或死亡风险的增加无关.
- 临床医生可以考虑在接受血液透析的患者中为血压管理处方α阻塞剂.
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