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慢性肾脏病患者血压测量:是时候改变我们的临床实践了——一项全面综述

Measurement of Blood Pressure in Chronic Kidney Disease: Time to Change Our Clinical Practice - A Comprehensive Review.

作者信息

Nagaraju Shankar Prasad, Shenoy Srinivas Vinayak, Rao Indu Ramachandra, Bhojaraja Mohan V, Rangaswamy Dharshan, Prabhu Ravindra Attur

机构信息

Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India.

出版信息

Int J Nephrol Renovasc Dis. 2022 Feb 9;15:1-16. doi: 10.2147/IJNRD.S343582. eCollection 2022.

Abstract

Chronic kidney disease (CKD) is extremely common all over the world and is strongly linked to cardiovascular disease (CVD). The great majority of CKD patients have hypertension, which raises the risk of cardiovascular disease (CVD), end-stage kidney disease, and mortality. Controlling hypertension in patients with CKD is critical in our clinical practice since it slows the course of the disease and lowers the risk of CVD. As a result, accurate blood pressure (BP) monitoring is crucial for CKD diagnosis and therapy. Three important guidelines on BP thresholds and targets for antihypertensive medication therapy have been published in the recent decade emphasizing the way we measure BP. For both office BP and out-of-office BP measuring techniques, their clinical importance in the management of hypertension has been well defined. Although BP measurement is widely disseminated and routinely performed in most clinical settings, it remains unstandardized, and practitioners frequently fail to follow the basic recommendations to avoid measurement errors. This may lead to misdiagnosis and wrong management of hypertension, especially in CKD patients. Here, we review presently available all BP measuring techniques and their use in clinical practice and the recommendations from various guidelines and research gaps emphasizing CKD patients.

摘要

慢性肾脏病(CKD)在全球极为常见,且与心血管疾病(CVD)密切相关。绝大多数CKD患者患有高血压,这会增加心血管疾病(CVD)、终末期肾病及死亡风险。在临床实践中,控制CKD患者的高血压至关重要,因为这能减缓疾病进程并降低CVD风险。因此,准确的血压(BP)监测对于CKD的诊断和治疗至关重要。近十年来已发布了三项关于抗高血压药物治疗的血压阈值和目标的重要指南,强调了我们测量血压的方式。对于诊室血压和诊室外血压测量技术,它们在高血压管理中的临床重要性已得到明确界定。尽管血压测量在大多数临床环境中广泛普及且常规进行,但仍未标准化,从业者经常未能遵循基本建议以避免测量误差。这可能导致高血压的误诊和错误管理,尤其是在CKD患者中。在此,我们回顾目前可用的所有血压测量技术及其在临床实践中的应用,以及各种指南的建议和强调CKD患者的研究空白。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55e8/8843793/02ad6f02b7a0/IJNRD-15-1-g0001.jpg

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