Shafiee Mohammad Ali, Chamanian Pouyan, Shaker Pouyan, Shahideh Yasmin, Broumand Behrooz
Division of General Internal Medicine, Department of Medicine, Toronto General Hospital, Toronto, ON M2G 2C4, Canada.
Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital Department of Nephrology, Iran University of Medical Sciences, Tehran 1449614535, Iran.
Healthcare (Basel). 2017 Sep 2;5(3):52. doi: 10.3390/healthcare5030052.
Cardiovascular complications are the most prominent causes of morbidity and mortality among chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients undergoing standard hemodialysis (HD) therapy. Cardiovascular disease risk is increased significantly through persistent hypertension and blood pressure (BP) fluctuation, which are the most common complications of CKD. It was hypothesized that an extended approach with lengthier and more frequent dialysis sessions, referred to in this paper as "extended hemodialysis" (EHD), can potentially lower and stabilize blood pressure, and consequently reduce the rate of morbidity and mortality. A greater reduction of volume (salt and water) with higher frequency can improve patient quality of life (QOL). Eleven papers, including clinical trials and systematic reviews were chosen and analyzed. The extracted data was used to evaluate the change in blood pressure levels between standard HD and EHD. Overall, the studies showed that EHD resulted in improved blood pressure management; therefore, we concluded that there will be a decrease in cardiovascular disease risk, stroke, and morbidity and mortality rate. There will be also an improvement in patient QOL due to beneficial effects of the EHD.
心血管并发症是接受标准血液透析(HD)治疗的慢性肾脏病(CKD)和终末期肾病(ESRD)患者发病和死亡的最主要原因。通过持续性高血压和血压(BP)波动,心血管疾病风险显著增加,而这是CKD最常见的并发症。据推测,一种延长透析时间和增加透析频率的扩展方法,在本文中称为“延长血液透析”(EHD),可能会降低并稳定血压,从而降低发病率和死亡率。更频繁地大量清除(盐和水)可改善患者生活质量(QOL)。我们选取并分析了11篇论文,包括临床试验和系统评价。提取的数据用于评估标准HD和EHD之间血压水平的变化。总体而言,研究表明EHD可改善血压管理;因此,我们得出结论,心血管疾病风险、中风以及发病率和死亡率将会降低。由于EHD的有益作用,患者的QOL也将得到改善。