Habas Elmukhtar, Habas Eshrak, Khan Fahmi Y, Rayani Amnna, Habas Aml, Errayes Mehdi, Farfar Khalifa L, Elzouki Abdel-Naser Y
Internal Medicine, Hamad Medical Corporation, Doha, QAT.
Internal Medicine, Hamad General Hospital, Doha, QAT.
Cureus. 2022 Apr 18;14(4):e24244. doi: 10.7759/cureus.24244. eCollection 2022 Apr.
Hypertension (HTN) is common in chronic kidney disease (CKD), and it may aggravate CKD progression. The optimal blood pressure (BP) value in CKD patients is not established yet, although systolic BP ≤130 mmHg is acceptable as a target. Continuous BP monitoring is essential to detect the different variants of high BP and monitor the treatment response. Various methods of BP measurement in the clinic office and at home are currently used. One of these methods is ambulatory BP monitoring (ABPM), by which BP can be closely assessed for even diurnal changes. We conducted a non-systematic literature review to explore and update the association between high BP and the course of CKD and to review various BP monitoring methods to determine the optimal method for BP recording in CKD patients. PubMed, EMBASE, Google, Google Scholar, and Web Science were searched for published reviews and original articles on BP and CKD by using various phrases and keywords such as "hypertension and CKD", "CKD progression and hypertension", "CKD stage and hypertension", "BP control in CKD", "BP measurement methods", "diurnal BP variation effect on CKD progression", and "types of hypertension." We evaluated and discussed published articles relevant to the review objective. Before preparing the final draft of this article, each author was assigned a section of the topic to read, research deeply, and write a summary about the assigned section. Then a summary of each author's contribution was collected and discussed in several group sessions. Early detection of high BP is essential to prevent CKD development and progression. Although the latest Kidney Disease Improving Global Outcomes (KDIGO) guidelines suggest that a systolic BP ≤120 mmHg is the target toprevent CKD progression, systolic BP ≤130 mmHg is universally recommended.ABPM is a promising method to diagnose and follow up on BP control; however, the high cost of the new devices and patient unfamiliarity with them have proven to be major disadvantages with regard to this method.
高血压（HTN）在慢性肾脏病（CKD）中很常见，并且可能会加重CKD的进展。尽管收缩压≤130 mmHg作为目标是可以接受的，但CKD患者的最佳血压（BP）值尚未确定。持续的血压监测对于检测高血压的不同变体以及监测治疗反应至关重要。目前临床上和家庭中使用了各种血压测量方法。其中一种方法是动态血压监测（ABPM），通过这种方法可以密切评估血压的昼夜变化。我们进行了一项非系统性文献综述，以探索和更新高血压与CKD病程之间的关联，并回顾各种血压监测方法，以确定CKD患者血压记录的最佳方法。通过使用各种短语和关键词，如“高血压与CKD”、“CKD进展与高血压”、“CKD分期与高血压”、“CKD中的血压控制”、“血压测量方法”、“昼夜血压变化对CKD进展的影响”以及“高血压类型”，在PubMed、EMBASE、谷歌、谷歌学术和网络科学中搜索关于血压和CKD的已发表综述和原始文章。我们评估并讨论了与综述目标相关的已发表文章。在准备本文的最终草稿之前，每位作者都被分配了该主题的一个部分进行阅读、深入研究并撰写关于所分配部分的总结。然后收集每位作者的贡献总结，并在几次小组会议上进行讨论。早期发现高血压对于预防CKD的发生和进展至关重要。尽管最新的改善全球肾脏病预后（KDIGO）指南建议收缩压≤120 mmHg是预防CKD进展的目标，但普遍推荐收缩压≤130 mmHg。ABPM是一种有前景的诊断和随访血压控制的方法；然而，新设备的高成本以及患者对它们的不熟悉已被证明是该方法的主要缺点。
