Suppr超能文献

2021年慢性肾脏病的血压目标:永无休止的指南困境。

Blood pressure targets in CKD 2021: the never-ending guidelines debacle.

作者信息

Carriazo Sol, Sarafidis Pantelis, Ferro Charles J, Ortiz Alberto

机构信息

Department of Medicine, School of Medicine, Universidad Autonoma de Madrid, Madrid, Spain.

Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloníki, Greece.

出版信息

Clin Kidney J. 2022 Feb 11;15(5):845-851. doi: 10.1093/ckj/sfac014. eCollection 2022 May.

Abstract

In 2021, two updated clinical guidelines were published, providing guidance on blood pressure (BP) targets for people with chronic kidney disease (CKD). Kidney Disease: Improving Global Outcomes (KDIGO) updated its 2012 Clinical Practice Guideline for the Management of BP in CKD. Different systolic blood pressure (SBP) and diastolic blood pressure (DBP) targets for CKD (<130/80 and <140/90 mmHg, respectively, for people with a urinary albumin: creatinine ratio >30 mg/g or without pathological albuminuria) were replaced by a single number: an SBP target of <120 mmHg is suggested, when tolerated. This represents a major decrease in the SBP target and the abandonment of DBP targets. The European Society of Cardiology (ESC) also published a 2021 Clinical Guideline on Cardiovascular Disease Prevention in Clinical Practice that updates a prior 2016 guideline on prevention and the 2018 ESC/European Society of Hypertension Clinical Practice Guidelines for the Management of Arterial Hypertension. The 2021 ESC guideline was endorsed by 12 European scientific societies. The recommended office BP targets for people with CKD are <140-130 mmHg SBP (lower SBP is acceptable if tolerated) and <80 mmHg DBP. The question is: What should the practicing physician do now: treat hypertension in people with CKD to an SBP target of <120 mmHg or to a target of <140-130 mmHg? Major guideline bodies are aware of the activities of other major players. There is an urgent need for guideline bodies to establish communication channels, search consensus on major issues that impact the health of hundreds of millions of people worldwide and end individualism in guidelines generation.

摘要

2021年,发布了两项更新的临床指南,为慢性肾脏病(CKD)患者的血压(BP)目标提供指导。改善全球肾脏病预后组织(KDIGO)更新了其2012年慢性肾脏病血压管理临床实践指南。慢性肾脏病不同的收缩压(SBP)和舒张压(DBP)目标(尿白蛋白:肌酐比值>30mg/g或无病理性蛋白尿的患者,分别为<130/80mmHg和<140/90mmHg)被一个单一数值取代:建议在耐受的情况下,收缩压目标为<120mmHg。这代表着收缩压目标大幅降低,并且放弃了舒张压目标。欧洲心脏病学会(ESC)也发布了《2021年临床实践中心血管疾病预防临床指南》,更新了之前2016年的预防指南以及2018年ESC/欧洲高血压学会动脉高血压管理临床实践指南。2021年ESC指南得到了12个欧洲科学学会的认可。慢性肾脏病患者推荐的诊室血压目标为收缩压<140 - 130mmHg(如果耐受,较低的收缩压也是可以接受的)和舒张压<80mmHg。问题是:执业医师现在应该怎么做:将慢性肾脏病患者的高血压治疗至收缩压目标<120mmHg还是<140 - 130mmHg?主要的指南制定机构了解其他主要参与者的活动。迫切需要指南制定机构建立沟通渠道,就影响全球数亿人健康的重大问题寻求共识,并结束指南制定中的各自为政现象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ff0/9050556/92cf8c1f9377/sfac014fig1.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验