在住院透析患者中治疗耐阻性低血压的弗鲁德科尔提松:一个病例报告
Fnu Veerban1,2, Meenakshi Kurup1,2, Ibrahim Mohamed1,2
1Department of Internal Medicine, Division of Nephrology, State University of New York Downstate Health Sciences University, Brooklyn, USA.
Cureus
|October 22, 2025
概括
一名患有慢性病 (CKD) 和急性损伤 (AKI) 的患者在接受类固醇治疗后出现上腺功能衰竭. 弗鲁德科尔提松有效地控制了耐火性低血压,改善了血液透析耐受性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 一名74岁的妇女患有4期慢性病 (CKD),由于药物诱导的急性间歇性炎 (AIN) 导致急性损伤 (AKI).
- 用皮质类固醇治疗导致了二次上腺功能不全和持续的内透析性低血压 (IDH).
研究的目的:
- 报告一种耐火性低血压病例,该病例发生在CKD患者中,该患者患有因使用皮质类固醇而导致的副次上腺功能衰竭.
- 为了突出fludrocortisone在治疗急性住院患者的内透析性低血压中的有效性.
主要方法:
- 一个患有CKD,AKI和二次上腺功能不全的患者的病例介绍.
- 管理涉及压力剂量皮激素,米多德林,随后用于耐火性低血压的fludrocortisone.
- 在整个治疗过程中,血液动力学参数和血压都被监测.
主要成果:
- 患者经历了持续的低血压,尽管初始治疗.
- 添加fludrocortisone导致持续的血液动力学改善和血压升高.
- 顺利的血液透析耐受性在 2.5 个月的弗鲁德科尔提松治疗中获得.
结论:
- 皮质类固醇诱导的上腺抑制是CKD患者呈现耐火性低血压的关键考虑因素.
- 弗鲁德科尔提松可以有效地管理因上腺功能不充分而导致的内透析性低血压,即使功能最小.
- 早期识别和管理上腺功能不足对于改善CKD患者的治疗结果至关重要.
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