患有中度至重度慢性脏疾病的患者的脏化
Markus P Schlaich1,2, Felix Mahfoud3,4, Michael Böhm5
1Dobney Hypertension Centre, Medical School, Royal Perth Hospital Unit and RPH Research Foundation, University of Western Australia (M.P.S., S.S.).
Hypertension (Dallas, Tex. : 1979)
|October 29, 2025
概括
射频脏缩 (RDN) 能够有效降低无控高血压和慢性病 (CKD) 的患者的血压 (BP). 这项研究表明,RDN在中度至重度的CKD患者中提供持久的BP降低,而没有显著的安全问题.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
背景情况:
- 在慢性病 (CKD) 患者中,不受控制的高血压很普遍,增加了心血管风险.
- 射频脏缩 (RDN) 是一种在高血压患者中降低血压的程序.
- 全球SYMPLICITY注册表DEFINE包括超过3500名患有失控高血压的患者,包括中度至重度CKD患者.
研究的目的:
- 评估无线电频损伤 (RDN) 的疗效和安全性,在患有无控高血压和慢性病 (CKD) 的不同阶段的患者中.
- 为了比较血压 (BP) 变化和功能在3年内在根据基线估计的淋巴细胞过率 (eGFR) 分类的患者.
主要方法:
- 根据基线eGFR,患者被分为三组:没有CKD (eGFR≥60),CKD阶段3a (eGFR≥45至<60),CKD阶段3b (eGFR≥30至<45).
- 办公室缩血压,安全事件和eGFR在3年内进行了监测.
- 还分析了74名CKD第四阶段患者的一年数据.
主要成果:
- 3年后,在所有组中都观察到显著的血压降低: -17.2±28.1毫米升 (无CKD), -12.1±30.3毫米升 (CKD 3a) 和 -13.0±27.3毫米升 (CKD 3b).
- 在任何CKD组中都没有注意到EGFR的显著下降,而在没有CKD组中出现了轻微的下降.
- 在所有组中,三年死亡率为4.3% (无CKD),7.0% (CKD 3a) 和15.2% (CKD 3b),罕见的脏不良事件 (<1.0%) 在所有组中.
结论:
- 射频RDN在患有不受控制的高血压和中度至重的CKD的患者中提供了临床上有意义和持续的BP降低.
- 该程序显示了良好的安全性,没有显著的脏或血管并发症.
- 在CKD患者中,RDN可能是管理高血压的有价值的治疗选择.
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