在血液透析中治疗高血压的现实世界数据来自波兰大型数据库
Bartosz Symonides1, Maria Zaborska-Dworak1, Jacek Lewandowski1
1Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, Warsaw, Poland.
Kidney & blood pressure research
|July 15, 2024
概括
宁-血管素系统阻断剂 (RASBs) 可以安全地给血液透析 (HD) 患者用保存的尿液,即使在多种抗高血压药物. 这项研究表明,RASB在这个复杂的患者群体中有效管理高血压.
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:
- 高血压在末期脏病 (ESKD) 患者接受血液透析 (HD) 中非常普遍,影响72-88%.
- 指导方针推宁-血管酶系统阻断剂 (RASBs) 用于脏疾病,但由于担心功能下降和尿症,它们在患有保存性尿尿症的HD患者的使用往往是有限的.
- 这项研究探讨了RASB在高血压HD患者的现实使用情况,这些患者有保存的残留尿液.
研究的目的:
- 为了比较临床特征,血压控制,安全性和多种抗高血压疗法的高血压HD患者的血液透析充分性.
- 评估RASBs与非RASB疗法在患有保留残留尿路症的HD患者中的使用情况.
主要方法:
- 一个由5879名HD患者组成的子组从一个大型HD提供者中被选中.
- 接受至少三种抗高血压药物 (包括利尿剂) 的患者与接受RASB治疗的患者和没有RASB治疗的患者进行了比较.
- 分析了临床特征,血压,安全参数和HD的充分性.
主要成果:
- RASB患者的人口结构相似,但干燥体重较低,心血管疾病的患病率更高.
- RASB患者表现出较高的缩血压,使用更多的抗高血压药物,以及更长的透析年份和每周透析时间.
- 血清水平在RASB组略高,但显着更高.
结论:
- 素-血管素系统阻断剂 (RASBs) 可以安全地用于血液透析 (HD) 患者,即使在用利尿剂治疗时,也可以保存残留利尿症.
- 在患有多种并发症的HD患者中,RASBs提供了超出血压控制的好处.
- 在RASB治疗的HD患者中,潜在的高血症可以通过饮食调整和优化HD处方来管理.
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