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血液透析人群高血压的管理:文献综述

Management of hypertension in the hemodialysis population: a review of the literature.

作者信息

Enam Nabela, Kakkad Kavita, Amin Akshay, Lever Carole

机构信息

School of Medicine, University of Maryland, Baltimore, MD, USA ; Medstar Union Memorial Hospital, Baltimore, MD, USA.

Medstar Union Memorial Hospital, Baltimore, MD, USA.

出版信息

J Community Hosp Intern Med Perspect. 2014 Jul 31;4(3). doi: 10.3402/jchimp.v4.24055. eCollection 2014.

DOI:10.3402/jchimp.v4.24055
PMID:25147635
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4120054/
Abstract

OBJECTIVE

The objective of this paper was to propose an algorithm for approaching hypertensive hemodialysis patients admitted to the hospital for hypertensive urgency.

METHODS

A literature search was conducted using PubMed (Medline). Articles selected were limited to humans and the English language.

RESULTS

WE IDENTIFIED EIGHT MANAGEMENT MODALITIES INCLUDING: short-daily and nocturnal dialysis, sodium restriction, sodium profiling, antihypertensive medications, sympathetic denervation, bilateral nephrectomy, and bioimpedance spectroscopy. The benefits and drawbacks of each were investigated and discussed before implementation into the algorithm.

DISCUSSION

The algorithm presented suggests a linear approach to patient care, but treatment modalities may not be mutually exclusive, and additional factors, such as patient compliance and individual health status, should be taken into account to provide patients with optimum care.

摘要

目的

本文的目的是提出一种针对因高血压急症入院的高血压血液透析患者的处理算法。

方法

使用PubMed(医学索引)进行文献检索。所选文章仅限于人类且为英文。

结果

我们确定了八种管理模式,包括:每日短程和夜间透析、钠限制、钠剖析、抗高血压药物、交感神经去神经支配、双侧肾切除术和生物电阻抗光谱法。在将每种模式纳入算法之前,对其利弊进行了研究和讨论。

讨论

所提出的算法建议采用线性方法进行患者护理,但治疗模式可能并非相互排斥,并且应考虑其他因素,如患者的依从性和个体健康状况,以便为患者提供最佳护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9f9/4120054/d0194818d397/JCHIMP-4-24055-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9f9/4120054/d0194818d397/JCHIMP-4-24055-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9f9/4120054/d0194818d397/JCHIMP-4-24055-g001.jpg

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本文引用的文献

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Saudi J Kidney Dis Transpl. 2013 May;24(3):507-13. doi: 10.4103/1319-2442.111025.
2
Effect of lower sodium intake on health: systematic review and meta-analyses.低钠摄入对健康的影响:系统评价和荟萃分析。
BMJ. 2013 Apr 3;346:f1326. doi: 10.1136/bmj.f1326.
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Effect of fluid management guided by bioimpedance spectroscopy on cardiovascular parameters in hemodialysis patients: a randomized controlled trial.
Editor's Note.
编者按。
J Community Hosp Intern Med Perspect. 2014 Jul 31;4(3). doi: 10.3402/jchimp.v4.25309. eCollection 2014.
生物阻抗谱指导下的液体管理对血液透析患者心血管参数的影响:一项随机对照试验。
Am J Kidney Dis. 2013 Jun;61(6):957-65. doi: 10.1053/j.ajkd.2012.12.017. Epub 2013 Feb 15.
4
Renal sympathetic denervation for treatment of resistant hypertension: a systematic review.肾去交感神经术治疗耐药性高血压:系统评价。
J Clin Hypertens (Greenwich). 2013 Jan;15(1):75-84. doi: 10.1111/jch.12027. Epub 2012 Oct 26.
5
Effect of frequent or extended hemodialysis on cardiovascular parameters: a meta-analysis.频繁或延长血液透析对心血管参数的影响:荟萃分析。
Am J Kidney Dis. 2012 May;59(5):689-99. doi: 10.1053/j.ajkd.2011.12.020. Epub 2012 Feb 25.
6
Effect of lowering blood pressure on cardiovascular events and mortality in patients on dialysis: a systematic review and meta-analysis of randomised controlled trials.降低血压对透析患者心血管事件及死亡率的影响:一项随机对照试验的系统评价与荟萃分析
Lancet. 2009 Mar 21;373(9668):1009-15. doi: 10.1016/S0140-6736(09)60212-9. Epub 2009 Feb 25.
7
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Nephrol Dial Transplant. 2008 Aug;23(8):2634-46. doi: 10.1093/ndt/gfn010. Epub 2008 Apr 3.
8
Revisiting the dialysate sodium prescription as a tool for better blood pressure and interdialytic weight gain management in hemodialysis patients.重新审视透析液钠处方,将其作为改善血液透析患者血压和透析间期体重增加管理的一种手段。
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A systematic review of the effect of nocturnal hemodialysis on blood pressure, left ventricular hypertrophy, anemia, mineral metabolism, and health-related quality of life.夜间血液透析对血压、左心室肥厚、贫血、矿物质代谢及健康相关生活质量影响的系统评价
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