Zazgornik J, Biesenbach G, Forstenlehner M, Stummvoll K
Allgemeines öffentliches Krankenhaus der Stadt Linz, II. Medizinische Abteilung, Austria.
Clin Nephrol. 1997 Dec;48(6):337-40.
Hypertension is frequently observed in end-stage renal failure. We analysed the incidence and severity of hypertension as well as antihypertensive treatment in a large group of patients on renal replacement therapy (RRT). Questionnaires were sent to all 49 dialysis centers caring for a total of 2090 patients on RRT in Austria. Hypertension was classified as mild, moderate or severe according to WHO criteria. 22 dialysis centers returned completed questionnaires accounting for 1087 patients on RRT. Of these 653 (60%) patients were hypertensive; 425 (39%) patients had mild or moderate, while 228 (21%) patients had severe hypertension. Patients with mild or moderate hypertension need on average 1.5, while those with severe hypertension on average 3.3 antihypertensive drugs. Calcium antagonists were the antihypertensive drugs most frequently administered, in 71% of the patients, followed by ACE inhibitors, alpha- and beta-blockers. Despite multidrug antihypertensive therapy severe hypertension is still a serious problem in patients on RRT. Tassin's center experience showed that longer dialysis time normalizes hypertension and reduces the requirement of antihypertensive treatment in patients on hemodialysis.
高血压在终末期肾衰竭患者中很常见。我们分析了一大组接受肾脏替代治疗（RRT）患者的高血压发病率、严重程度以及抗高血压治疗情况。我们向奥地利所有49个照顾总共2090例接受RRT患者的透析中心发放了调查问卷。根据世界卫生组织标准，高血压被分为轻度、中度或重度。22个透析中心返回了完整的调查问卷，涉及1087例接受RRT的患者。其中653例（60%）患者患有高血压；425例（39%）患者患有轻度或中度高血压，而228例（21%）患者患有重度高血压。轻度或中度高血压患者平均需要1.5种抗高血压药物，而重度高血压患者平均需要3.3种。钙拮抗剂是最常使用的抗高血压药物，71%的患者使用，其次是血管紧张素转换酶抑制剂、α和β受体阻滞剂。尽管采用了多种药物进行抗高血压治疗，但重度高血压在接受RRT的患者中仍然是一个严重问题。塔桑中心的经验表明，延长透析时间可使接受血液透析的患者血压恢复正常，并减少抗高血压治疗的需求。
