针对韩国血液透析患者的目标血压,以获得最佳的生存率
Ji Eun Kim1,2, Yun Jin Choi3, Soon-Young Hwang4
1Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea.
Kidney research and clinical practice
|November 3, 2023
概括
对于血液透析患者来说,避免极低或极高的缩血压 (SBP) 对于生存至关重要. 保持SBP在120-160mmHg之间可能会优化结果,但需要进一步的研究来定制建议.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 公共卫生 公共卫生
背景情况:
- 高血压是血液透析患者心血管疾病的重要危险因素.
- 确定最佳血压 (BP) 目标对于改善这一群体的生存率至关重要.
研究的目的:
- 为了确定韩国血液透析患者的理想压缩压 (SBP) 和压缩压 (DBP) 目标.
- 分析BP水平和死亡率之间的关联,使用大型的国家数据集和汇总先前的研究.
主要方法:
- 韩国脏透析系统 (KORDS) 数据集的分析,其中包括70,607名血液透析患者.
- 根据SBP (<120,120-140,140-160,160-180,≥180 mmHg) 和DBP间隔对患者进行分类.
- 用多变量考克斯回归和聚合分析评估所有原因和心血管死亡率.
主要成果:
- 与SBP 120-140 mmHg相比,SBP <120 mmHg或≥180 mmHg的患者患有全因死亡的风险增加.
- DBP没有显示出与死亡率的显著关联.
- 心血管死亡率在SBP≥160 mmHg时增加;在没有糖尿病的年轻患者中观察到U形关联.
结论:
- 建议韩国血液透析患者避免极低 (<120 mmHg) 或不受控制的 (≥160 mmHg) SBP.
- 对于120-160 mmHg的SBP范围,需要进行进一步的研究,考虑到统一的BP测量和日内分析性低血压风险.
- 根据个体患者的风险因素定制的BP建议是必不可少的.
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