Monhart Václav
Vnitr Lek. 2016 Winter;62 Suppl 6:55-57.
There is no consensus of the opinion that the value of systolic blood pressure (SBP) is the most favourable for the treatment of hypertension in patients with chronic kidney disease (CKD). The interventional study SPRINT (The Systolic Blood Pressure Intervention Trial) demonstrated the significant reduction in major cardiovascular events and overall mortality with intensive control of SBP (< 120 mm Hg) in individuals with high risk, including those with CKD and mild proteinuria. Nephrologists should take into account the results of the SPRINT study in the determination of the optimal SBP in patients with CKD, but at the same time they pay the attention to the early detection of adverse events related to treatment, including disorders of electrolyte balance, acute renal impairment, hypotension, and side effects of medications.Key words: acute kidney injury - cardiovascular events - glomerular filtration rate - chronic kidney disease - proteinuria - systolic blood pressure.
对于收缩压(SBP)值是慢性肾脏病(CKD)患者高血压治疗的最有利值,目前尚无一致意见。干预性研究SPRINT(收缩压干预试验)表明,在包括CKD和轻度蛋白尿患者在内的高危个体中,强化控制SBP(<120 mmHg)可显著降低主要心血管事件和总体死亡率。肾病学家在确定CKD患者的最佳SBP时应考虑SPRINT研究的结果,但同时要注意早期发现与治疗相关的不良事件,包括电解质平衡紊乱、急性肾功能损害、低血压和药物副作用。关键词:急性肾损伤-心血管事件-肾小球滤过率-慢性肾脏病-蛋白尿-收缩压