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血液透析患者的血压目标。

Blood pressure targets for hemodialysis patients.

机构信息

Section of Nephrology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.

Section of Nephrology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.

出版信息

Kidney Int. 2017 Oct;92(4):816-823. doi: 10.1016/j.kint.2017.01.038.

Abstract

The association between blood pressure (BP) and mortality is unique in hemodialysis patients compared with that in the general population. This is because of an altered benefit-risk balance associated with BP reduction in these patients. An adequately designed study comparing BP targets in hemodialysis patients remains to be conducted. The current evidence available to guide dialysis providers regarding treatment strategies for managing hypertension in this population is limited to large observational studies and small randomized controlled trials. In this opinion article, we review these data and discuss the key points regarding BP management for hemodialysis patients. Our aim is to provide a practical opinion regarding BP targets that nephrologists can incorporate into clinical practice, with a focus on moving away from dialysis unit BPs and focusing on out-of-dialysis unit BPs.

摘要

与普通人群相比,血液透析患者的血压(BP)与死亡率之间的关系是独特的。这是因为与这些患者的 BP 降低相关的获益-风险平衡发生了改变。仍需要进行一项设计合理的比较血液透析患者的 BP 目标的研究。目前可用于指导透析提供者针对该人群管理高血压的治疗策略的证据仅限于大型观察性研究和小型随机对照试验。在这篇观点文章中,我们回顾了这些数据,并讨论了有关血液透析患者 BP 管理的要点。我们的目的是提供一个关于肾科医生可以将其纳入临床实践的 BP 目标的实用观点,重点是摆脱透析单位 BP,关注透析单位外 BP。

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