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双侧肾切除术:终末期肾病患者难治性高血压治疗中被遗忘的措施——病例报告及文献综述

Bilateral Nephrectomy, the Forgotten Measure in the Treatment of Refractory Hypertension in Patients With End-Stage Renal Disease: A Case Report and Literature Review.

作者信息

Aldiabat Mohammad, Alabdallah Khaled, Kofahi Ahmad, Aziz Shazia

机构信息

Internal Medicine, Lincoln Medical Center, New York, USA.

出版信息

Cureus. 2020 Jul 6;12(7):e9031. doi: 10.7759/cureus.9031.

Abstract

It's not uncommon for patients with end-stage renal disease (ESRD) to develop hypertension that is resistant to antihypertensive medications and volume control, making it a challenge to control blood pressure in those patients. In this article, we present a 71-year-old female with a history of ESRD on intermittent hemodialysis (IHD), who developed refractory hypertension despite the use of seven antihypertensive agents in addition to IHD. The patient underwent bilateral nephrectomy as a last resort therapy for managing resistant hypertension, which led to a significant improvement in blood pressure (BP) and decreasing the number and doses of antihypertensive agents. This article aims to raise the awareness and alertness of clinicians to the efficacy of bilateral nephrectomy as rescue therapy for refractory hypertension in hemodialysis patients.

摘要

终末期肾病(ESRD)患者出现对降压药物和容量控制均有抵抗的高血压并不罕见,这使得控制这些患者的血压成为一项挑战。在本文中,我们介绍了一名71岁的女性,她有ESRD病史,接受间歇性血液透析(IHD),尽管除IHD外还使用了七种降压药物,但仍出现了难治性高血压。该患者接受了双侧肾切除术,作为治疗难治性高血压的最后手段,这导致血压显著改善,并减少了降压药物的数量和剂量。本文旨在提高临床医生对双侧肾切除术作为血液透析患者难治性高血压抢救治疗疗效的认识和警觉性。

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