Flythe Jennifer E, Brunelli Steven M
aDivision of Nephrology and Hypertension, Department of Medicine, UNC School of Medicine, University of North Carolina Kidney Center, Chapel Hill, North Carolina bDaVita Clinical Research, Minneapolis, Minnesota, USA.
Curr Opin Nephrol Hypertens. 2015 Mar;24(2):163-9. doi: 10.1097/MNH.0000000000000107.
This review focuses on recent evidence linking blood pressure variability (BPV) to adverse clinical outcomes in the chronic hemodialysis patient population.
BPV is an increasingly recognized poor prognostic factor in the general population. A growing body of evidence suggests that both short-term and long-term BPV are associated with adverse events among chronic dialysis patients. Over the last 18 months, several studies have linked long-term BPV (considered dialysis treatment to dialysis treatment) to all-cause and cardiovascular morbidity and mortality. Similar results have been demonstrated for short-term (considered as intradialytic) BPV and clinical outcomes. Further studies substantiating these findings and examining potential BPV mitigation strategies are needed. Additionally, a BPV metric that is easily calculated and tracked in the clinical setting is necessary before BPV can become a routine component of clinical monitoring.
Recent observational data demonstrate an association between short-term and long-term BPV and adverse outcomes among chronic hemodialysis patients. Further research is needed to identify strategies that mitigate this risk and to translate these findings into clinical practice.
本综述重点关注近期有关血压变异性（BPV）与慢性血液透析患者不良临床结局之间关联的证据。
BPV在普通人群中是一个越来越被认可的不良预后因素。越来越多的证据表明，短期和长期BPV均与慢性透析患者的不良事件相关。在过去18个月里，多项研究将长期BPV（从一次透析治疗到下一次透析治疗）与全因发病率和心血管发病率及死亡率联系起来。短期（透析期间）BPV与临床结局也有类似结果。需要进一步研究来证实这些发现并探讨潜在的BPV缓解策略。此外，在BPV成为临床监测的常规组成部分之前，需要一种在临床环境中易于计算和追踪的BPV指标。
近期观察性数据表明，短期和长期BPV与慢性血液透析患者的不良结局之间存在关联。需要进一步研究以确定减轻这种风险的策略，并将这些发现转化为临床实践。
