Division of Nephrology and Hypertension, Department of Medicine, S-2332 Medical Center North, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-2372, USA.
J Am Soc Nephrol. 2010 Jul;21(7):1086-92. doi: 10.1681/ASN.2010030236. Epub 2010 Jun 24.
BP control is critical in the treatment of patients with chronic kidney disease. Recent guidelines now recommend a BP goal of <130/80 mmHg. Clinical trials using a randomized, intention-to-treat design have not established the benefits of this goal; rather, observational data and secondary or subgroup analyses drove the development of the new guidelines. A variety of observations suggest potential adverse events associate with achieving too low a BP in patients with chronic kidney disease, and ongoing randomized trials will have to establish the benefits or risks of meeting this goal.
血压控制对于慢性肾脏病患者的治疗至关重要。最近的指南建议血压目标值<130/80mmHg。采用随机、意向治疗设计的临床试验并未证实该目标值的益处；相反，观察性数据和二级或亚组分析推动了新指南的制定。各种观察结果表明，在慢性肾脏病患者中，血压降得过低可能会导致潜在的不良事件，而正在进行的随机试验将不得不确定达到这一目标的益处或风险。
