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尼日利亚西南部一家三级医院维持性血液透析的慢性肾病患者透析期间的血压变化:一项为期2年的回顾性研究

Intradialysis blood pressure changes among chronic kidney disease patients on maintenance haemodialysis in a tertiary hospital south - south Nigeria: a 2 year retrospective study.

作者信息

Okpa Henry Ohem, Effa Emmanuel Edet, Oparah Sidney Kelechi, Chikezie John Austin, Bisong Elvis Mbu, Mbu Patrick Ntui, Otokpa Daniel Emmanuel

机构信息

Department of Internal Medicine, Renal Unit, University of Calabar Teaching Hospital, Calabar, Nigeria.

Department of Internal Medicine, University of Calabar, Calabar, Nigeria.

出版信息

Pan Afr Med J. 2019 Jun 6;33:91. doi: 10.11604/pamj.2019.33.91.17000. eCollection 2019.

Abstract

INTRODUCTION

Haemodialysis (HD) which is a form of renal replacement therapy commonly prescribed for patients with chronic kidney disease (CKD). However, it is not without deleterious haemodynamic responses which may occur either during or immediately after the termination of the procedure. These may include hypotension or hypertension.

METHODS

This was a retrospective study that reviewed chronic kidney disease (CKD) patients on maintenance haemodialysis at the renal unit of University of Calabar Teaching Hospital, Calabar, Nigeria. In all, 71 patients were reviewed but only 64 patients had complete data for analysis. Socio-demographic, clinical and biochemical data were obtained from the records in the dialysis unit.

RESULTS

There were more males 38 (59.4%) than females 26 (40.6%) in the study. The mean age was 51.71±15.43 years and 43.04±14.03years for males and females respectively. The prevalence of intradialysis hypertension 29 (45.3%) was higher than that of intradialysis hypotension 20 (31.3%) and the commonest cause of CKD requiring haemodialysis was diabetic nephropathy. The factors associated with intradialysis hypotension were lower post-dialysis systolic blood pressure (PDSBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and less number of antihypertensive medications; while the factors associated with intradialysis hypertension were higher post-dialysis systolic blood pressure (SBP), MAP, greater number of antihypertensive medications and longer duration of haemodialysis.

CONCLUSION

Our study shows that there are several modifiable factors associated with blood pressure fluctuations among CKD patients on maintenance haemodialysis in the renal unit of the University of Calabar Teaching Hospital, Calabar.

摘要

引言

血液透析(HD)是一种常用于慢性肾脏病(CKD)患者的肾脏替代治疗方式。然而,该治疗并非没有有害的血流动力学反应,这些反应可能在治疗过程中或治疗结束后立即出现。这些反应可能包括低血压或高血压。

方法

这是一项回顾性研究,对尼日利亚卡拉巴尔大学教学医院肾脏科接受维持性血液透析的慢性肾脏病(CKD)患者进行了评估。总共评估了71例患者,但只有64例患者有完整数据用于分析。社会人口统计学、临床和生化数据从透析单元的记录中获取。

结果

研究中男性有38例(59.4%),多于女性的26例(40.6%)。男性的平均年龄为51.71±15.43岁,女性为43.04±14.03岁。透析期间高血压的患病率为29例(45.3%),高于透析期间低血压的患病率20例(31.3%),需要血液透析的CKD最常见病因是糖尿病肾病。与透析期间低血压相关的因素包括透析后收缩压(PDSBP)、舒张压(DBP)、平均动脉压(MAP)较低以及抗高血压药物数量较少;而与透析期间高血压相关的因素包括透析后收缩压(SBP)、MAP较高、抗高血压药物数量较多以及血液透析持续时间较长。

结论

我们的研究表明,在卡拉巴尔大学教学医院肾脏科接受维持性血液透析的CKD患者中,有几个可改变的因素与血压波动有关。

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