Iatridi Fotini, Theodorakopoulou Marieta P, Papagianni Aikaterini, Sarafidis Pantelis
Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Greece.
J Hypertens. 2022 Nov 1;40(11):2120-2129. doi: 10.1097/HJH.0000000000003247. Epub 2022 Aug 8.
Intradialytic hypertension (IDH), that is, a paradoxical rise in blood pressure (BP) during or immediately after a hemodialysis session, affects approximately 10-15% of the hemodialysis population. It is currently recognized as a phenomenon of major clinical significance as recent studies have shown that BP elevation extends to the whole interdialytic interval and associates with increased cardiovascular and all-cause mortality. The pathophysiology of IDH is complex involving volume and sodium overload, endothelial dysfunction, excess renin-angiotensin-aldosterone system and sympathetic nervous system activation, and other mechanisms. For several years, there was a scarcity of studies regarding IDH treatment; recently, however, several attempts to examine the effect of nonpharmacological and pharmacological measures on BP levels in IDH are made. This review attempts to summarize this latest evidence in the field of management of IDH and discuss areas for future research.
透析中高血压（IDH），即血液透析过程中或透析结束后不久血压（BP）反常升高，影响着约10%至15%的血液透析人群。目前，它被认为是一种具有重大临床意义的现象，因为最近的研究表明，血压升高会持续到整个透析间期，并与心血管疾病和全因死亡率增加相关。IDH的病理生理学很复杂，涉及容量和钠过载、内皮功能障碍、肾素-血管紧张素-醛固酮系统和交感神经系统激活以及其他机制。多年来，关于IDH治疗的研究很少；然而，最近有人尝试研究非药物和药物措施对IDH患者血压水平的影响。本综述试图总结IDH管理领域的最新证据，并讨论未来研究的方向。
