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影响肾切除术治疗肾性高血压成功率的预测因素:多中心研究。

Predictive Factors Affecting the Success of Nephrectomy for the Treatment of Nephrogenic Hypertension: Multicenter Study.

机构信息

Department of Urology, Health Sciences University, Adana City Training and Research Hospital, Adana, Turkey.

Department of Urology, Adana Seyhan State Hospital, Adana, Turkey.

出版信息

Urol Int. 2021;105(7-8):674-679. doi: 10.1159/000515652. Epub 2021 Apr 19.

Abstract

INTRODUCTION

The aim of our study is to evaluate the predictive factors affecting the success of treatment with nephrectomy in patients with poorly functioning kidney and nephrogenic hypertension.

METHODS

Data for patients who underwent nephrectomy with a diagnosis of nephrogenic hypertension in 3 centers between May 2010 and January 2020 were analyzed. In the postoperative period, if the blood pressure (BP) was below 140/90 mm Hg without medical treatment, it was accepted as complete response; if the arterial BP was below 140/90 mm Hg with medical treatment or less medication, it was accepted as partial response; and if BP did not decrease to normal values, it was accepted as unresponsive. Demographic characteristics, duration of hypertension, preoperative and postoperative BP values, and presence of metabolic syndrome were statistically evaluated.

RESULTS

Our study consisted of 91 patients with a mean preoperative hypertension duration of 23.3 ± 12.1 months. Among patients, 42 (46.2%) had complete response, 18 (19.8%) had partial response, and 31 (34.0%) had no response. Preoperative systolic and diastolic BP values were not effective on treatment success (p = 0.071, p = 0.973, respectively), but the increase in age and hypertension duration (p = 0.030 and p < 0.001, respectively) and the presence of metabolic syndrome (p = 0.002) significantly decreased the complete response rates.

CONCLUSIONS

Preoperative hypertension duration, advanced age, and presence of metabolic syndrome are predictive factors affecting the response to treatment in patients who undergo nephrectomy due to nephrogenic hypertension.

摘要

介绍

我们研究的目的是评估影响肾切除治疗效果的预测因素,这些患者的肾脏功能较差且患有肾性高血压。

方法

分析了 2010 年 5 月至 2020 年 1 月期间在 3 个中心因肾性高血压行肾切除术的患者的数据。术后,如果血压(BP)低于 140/90mmHg 且未接受药物治疗,则视为完全缓解;如果动脉 BP 低于 140/90mmHg 且接受药物治疗或减少药物治疗,则视为部分缓解;如果 BP 未降至正常,则视为无反应。对人口统计学特征、高血压持续时间、术前和术后 BP 值以及代谢综合征的存在进行了统计学评估。

结果

我们的研究共包括 91 例患者,平均术前高血压持续时间为 23.3 ± 12.1 个月。其中 42 例(46.2%)患者完全缓解,18 例(19.8%)患者部分缓解,31 例(34.0%)患者无反应。术前收缩压和舒张压值对治疗效果无影响(p = 0.071,p = 0.973),但年龄和高血压持续时间的增加(p = 0.030 和 p < 0.001)以及代谢综合征的存在(p = 0.002)显著降低了完全缓解率。

结论

术前高血压持续时间、高龄和代谢综合征是影响因肾性高血压行肾切除术患者治疗反应的预测因素。

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