Saldanha L F, Weiler E W, Gonick H C
Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
Am J Kidney Dis. 1993 Feb;21(2):184-8. doi: 10.1016/s0272-6386(12)81091-2.
To assess the efficacy of blood pressure control in continuous ambulatory peritoneal dialysis (CAPD), blood pressure was examined sequentially in 63 CAPD patients transferred from hemodialysis (HD), and in 97 patients started de novo on CAPD (NEW), over periods ranging from 3 to 63 months. Blood pressure changes were related to changes in body weight, hematocrit, and treatment with recombinant human erythropoietin (rHu-EPO), as well as to changes in antihypertensive drug requirements. Both groups of patients showed an immediate improvement in blood pressure control at 1 month, as manifested by an absolute decrease in blood pressure in HD patients (-4.3% +/- 2.1% [SEM], P < 0.05) and by a decrease in antihypertensive drug requirements in NEW patients (from 78% to 43.3%). This early improvement in blood pressure appeared to be volume-related, as reflected by changes in body weight. Both groups showed an additional decrement in blood pressure at approximately 6 months (-7.8% +/- 2.6% [SEM], P < 0.05, HD group; -3.4% +/- 2.4% [SEM], P < 0.05, NEW group). Treatment of anemia with rHu-EPO in 22 of the CAPD patients had no effect on blood pressure. CAPD thus appears to be more effective than HD in controlling blood pressure.
为评估持续性非卧床腹膜透析（CAPD）中血压控制的疗效，我们对63例从血液透析（HD）转为CAPD的患者以及97例初治CAPD患者（NEW）进行了为期3至63个月的序贯血压检查。血压变化与体重、血细胞比容、重组人促红细胞生成素（rHu-EPO）治疗的变化以及降压药物需求的变化相关。两组患者在1个月时血压控制均立即改善，HD患者血压绝对下降（-4.3%±2.1%[SEM]，P<0.05），NEW患者降压药物需求减少（从78%降至43.3%）。这种血压的早期改善似乎与容量相关，体重变化反映了这一点。两组在约6个月时血压均进一步下降（HD组为-7.8%±2.6%[SEM]，P<0.05；NEW组为-3.4%±2.4%[SEM]，P<0.05）。22例CAPD患者用rHu-EPO治疗贫血对血压无影响。因此，CAPD在控制血压方面似乎比HD更有效。
