Kim Yaeni, Kim Won, Kim Jwa-Kyung, Moon Ju Young, Park Samel, Park Cheol Whee, Park Hoon Suk, Song Sang Heon, Yoo Tae-Hyun, Lee So-Young, Lee Eun Young, Lee Jeonghwan, Jin Kyubok, Cha Dae Ryong, Cha Jin Joo, Han Sang Youb
Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University, Seoul, Republic of Korea.
Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Republic of Korea.
Electrolyte Blood Press. 2022 Dec;20(2):39-48. doi: 10.5049/EBP.2022.20.2.39. Epub 2022 Dec 30.
Diabetic kidney disease (DKD) is the most common cause of end-stage kidney disease. Blood pressure (BP) control can reduce the risks of cardiovascular (CV) morbidity, mortality, and kidney disease progression. Recently, the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines have suggested the implementation of a more intensive BP control with a target systolic BP (SBP) of <120 mmHg based on the evidence that the CV benefits obtained is outweighed by the kidney injury risk associated with a lower BP target. However, an extremely low BP level may paradoxically aggravate renal function and CV outcomes. Herein, we aimed to review the existing literature regarding optimal BP control using medications for DKD.
糖尿病肾病(DKD)是终末期肾病最常见的病因。血压(BP)控制可降低心血管(CV)发病、死亡风险以及肾病进展风险。最近,改善全球肾脏病预后组织(KDIGO)指南建议实施更强化的血压控制,目标收缩压(SBP)<120 mmHg,这是基于所获心血管益处大于较低血压目标相关肾损伤风险的证据。然而,极低的血压水平可能反常地加重肾功能及心血管结局。在此,我们旨在综述有关使用药物控制DKD最佳血压的现有文献。