透析患者应该使用哪些血压指标?
1Division of Nephrology, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.
Kidney research and clinical practice
|December 8, 2023
概括
对透析患者的血压 (BP) 目标进行辩论. 在透析期间降低血压可能是有害的,而透析外的测量更好地预测结果.
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
- 临床研究 临床研究
背景情况:
- 在一般人群中,血压 (BP) 控制得到了改善,较低的目标显示出更好的结果.
- 透析患者,特别是接受血液透析 (HD) 的患者,具有独特的特征,使得BP目标定义具有挑战性.
- 以前对透析患者的BP目标是基于一般人群研究,可能忽视了特定患者的需求.
研究的目的:
- 审查影响透析患者血压的因素.
- 讨论血液透析患者的个性化目标血压水平和维护策略.
- 纳入最近关于BP管理在这个独特的患者群体的文献.
主要方法:
- 对血液透析患者周透析BP的观察性研究的综述.
- 分析最近关于非透析血压测量的研究 (家庭血压,门诊血压监测).
- 关于透析患者血压目标和管理的当前文献综合.
主要成果:
- 观察性研究表明,较低的周透透析BP与HD患者的结果更差有关,可能是由于混因素.
- 在透析外的血压测量更能预测临床结果.
- 大规模的临床试验数据来确定透析患者的特定BP目标是有限的.
结论:
- 由于独特的生理因素和治疗效应,为透析患者确定最佳的BP目标仍然是一个挑战.
- 个性化BP目标和策略,考虑透析外的测量非常重要.
- 需要进一步的研究,以建立基于证据的血压推用于透析患者.
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