Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Hypertens Res. 2022 Nov;45(11):1713-1725. doi: 10.1038/s41440-022-01001-3. Epub 2022 Aug 18.
The term intradialytic hypertension (IDH) describes a paradoxical rise in blood pressure (BP) during or immediately after the hemodialysis session. Although it was formerly considered a phenomenon without clinical implications, current evidence suggests that IDH may affect up to 15% of hemodialysis patients and exhibit independent associations with future cardiovascular events and all-cause mortality. Furthermore, during the last decade, several studies have tried to elucidate the complex pathophysiological mechanisms responsible for this phenomenon. Volume overload, intradialytic sodium gain, overactivity of the sympathetic-nervous-system and renin-angiotensin-aldosterone system, endothelial dysfunction and dialysis-related electrolyte disturbances have been proposed to be involved in the pathogenesis of the BP increase during hemodialysis. This review attempts to summarize existing evidence on the epidemiology, pathophysiology and clinical characteristics of the distinct phenomenon of IDH.
术语“透析中高血压（IDH）”描述了血液透析过程中或结束后血压（BP）的反常升高。虽然 IDH 曾被认为是一种无临床意义的现象，但目前的证据表明，IDH 可能影响多达 15%的血液透析患者，并与未来的心血管事件和全因死亡率独立相关。此外，在过去十年中，多项研究试图阐明导致这种现象的复杂病理生理机制。容量超负荷、透析中钠的摄入、交感神经系统和肾素-血管紧张素-醛固酮系统的过度活跃、内皮功能障碍以及与透析相关的电解质紊乱被认为与血液透析过程中血压升高有关。这篇综述试图总结 IDH 的流行病学、病理生理学和临床特征的现有证据。
