切换至 "中华医学电子期刊资源库"

中华肾病研究电子杂志 ›› 2023, Vol. 12 ›› Issue (03) : 168 -171. doi: 10.3877/cma.j.issn.2095-3216.2023.03.009

综述

血液透析患者的血压靶目标值研究进展
李晓晨, 乔晞()   
  1. 030001 太原,山西医科大学第二医院、山西省肾脏病研究所、山西医科大学肾脏病研究所
  • 收稿日期:2022-08-01 出版日期:2023-06-28
  • 通信作者: 乔晞
  • 基金资助:
    山西省回国留学人员科研资助项目(2020-186); 山西省留学回国人员科技活动择优资助项目(2017-29)

Progress of research on target value of blood pressure in patients undergoing hemodialysis

Xiaochen Li, Xi Qiao()   

  1. Department of Nephrology, Second Hospital of Shanxi Medical University, Shanxi Provincial Institute for Kidney Disease, Kidney Disease Institute of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
  • Received:2022-08-01 Published:2023-06-28
  • Corresponding author: Xi Qiao
引用本文:

李晓晨, 乔晞. 血液透析患者的血压靶目标值研究进展[J/OL]. 中华肾病研究电子杂志, 2023, 12(03): 168-171.

Xiaochen Li, Xi Qiao. Progress of research on target value of blood pressure in patients undergoing hemodialysis[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2023, 12(03): 168-171.

血液透析(HD)是目前全球范围内使用最为普遍的肾脏替代治疗方式。HD患者死亡的首要原因是心血管系统疾病,而后者与患者血压水平密切相关。因此,血压控制非常重要。目前国内外对HD患者血压管理的靶目标值尚未有统一的意见。本文就HD患者血压管理的靶目标值与临床预后之间的关系研究进展进行了综述。

Hemodialysis (HD) is the most widely used renal replacement therapy in the world. The first cause of death in HD patients is cardiovascular disease, which is closely related to the blood pressure. Blood pressure control is very important. At present, there is no unified opinion on the target value of blood pressure management in HD patients in the world. This article reviewed the progress of research on relationship between target value of blood pressure management and clinical prognosis in HD patients.

表1 血液透析患者的血压靶目标值
[1]
Kalantar-Zadeh K, Jafar TH, Nitsch D, et al. Chronic kidney disease [J]. Lancet, 2021, 398(10302): 786-802.
[2]
GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 [J]. Lancet, 2020, 395(10225): 709-733.
[3]
Foreman KJ, Marquez N, Dolgert A, et al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories [J]. Lancet, 2018, 392(10159): 2052-2090.
[4]
Jankowski J, Floege J, Fliser D, et al. Cardiovascular disease in chronic kidney disease: pathophysiological insights and therapeutic options [J]. Circulation, 2021, 143(11): 1157-1172.
[5]
Jager KJ, Kovesdy C, Langham R, et al. A single number for advocacy and communication - worldwide more than 850 million individuals have kidney diseases [J]. Kidney Int, 2019, 96(5): 1048-1050.
[6]
Sarafidis PA, Persu A, Agarwal R, et al. Hypertension in dialysis patients: a consensus document by the European renal and cardiovascular medicine (EURECA-m) working group of the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) and the hypertension and the kidney working group of the European Society of Hypertension (ESH) [J]. J Hypertens, 2017, 35(4): 657-676.
[7]
Pecoits-Filho R, Okpechi IG, Donner JA, et al. Capturing and monitoring global differences in untreated and treated end-stage kidney disease, kidney replacement therapy modality, and outcomes [J]. Kidney Int Suppl, 2020, 10(1): e3-e9.
[8]
中华医学会肾脏病学分会专家组. 中国慢性肾脏病患者高血压管理指南(2023年版)[J]. 中华肾脏病杂志2023, 39(1): 48-80.
[9]
Thompson S, James M, Wiebe N, et al. Cause of death in patients with reduced kidney function [J]. J Am Soc Nephrol, 2015, 26(10): 2504-2511.
[10]
Bello AK, Okpechi IG, Osman MA, et al. Epidemiology of haemodialysis outcomes [J]. Nat Rev Nephrol, 2022, 18(6): 378-395.
[11]
Georgianos PI, Agarwal R. Blood pressure in hemodialysis: targets? [J]. Curr Opin Nephrol Hypertens, 2017, 26(6): 523-529.
[12]
Flythe JE, Chang TI, Gallagher MP, et al. Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) controversies conference [J]. Kidney Int, 2020, 97(5): 861-876.
[13]
Turner JM, Peixoto AJ. Blood pressure targets for hemodialysis patients [J]. Kidney Int, 2017, 92(4): 816-823.
[14]
中国医药教育协会肾病与血液净化专业委员会血液透析低血压防治专家组.血液透析中低血压防治专家共识(2022) [J]. 中华内科杂志2022, 61(3): 269-281.
[15]
Miskulin DC, Gassman J, Schrader R, et al. BP in dialysis: results of a pilot study [J]. J Am Soc Nephrol, 2018, 29(1): 307-316.
[16]
Van Buren PN. Evaluation and treatment of hypertension in end-stage renal disease patients on hemodialysis [J]. Curr Cardiol Rep, 2016, 18(12): 125.
[17]
Zager PG, Nikolic J, Brown RH, et al. " U" curve association of blood pressure and mortality in hemodialysis patients. Medical Directors of Dialysis Clinic, Inc [J]. Kidney Int, 1998, 54(2): 561-569.
[18]
Robinson BM, Tong L, Zhang J, et al. Blood pressure levels and mortality risk among hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study [J]. Kidney Int, 2012, 82(5): 570-580.
[19]
Hannedouche T, Roth H, Krummel T, et al. Multiphasic effects of blood pressure on survival in hemodialysis patients [J]. Kidney Int, 2016, 90(3): 674-684.
[20]
Port FK, Hulbert-Shearon TE, Wolfe RA, et al. Predialysis blood pressure and mortality risk in a national sample of maintenance hemodialysis patients [J]. Am J Kidney Dis, 1999, 33(3): 507-517.
[21]
Kalantar-Zadeh K, Kilpatrick RD, McAllister CJ, et al. Reverse epidemiology of hypertension and cardiovascular death in the hemodialysis population: the 58th annual fall conference and scientific sessions [J]. Hypertension, 2005, 45(4): 811-817.
[22]
Li Z, Lacson E Jr, Lowrie EG, et al. The epidemiology of systolic blood pressure and death risk in hemodialysis patients [J]. Am J Kidney Dis, 2006, 48(4): 606-615.
[23]
Bansal N, McCulloch CE, Lin F, et al. Blood pressure and risk of cardiovascular events in patients on chronic hemodialysis: the CRIC study (Chronic Renal Insufficiency Cohort) [J]. Hypertension, 2017, 70(2): 435-443.
[24]
Agarwal R, Sinha AD. Cardiovascular protection with antihypertensive drugs in dialysis patients: systematic review and meta-analysis [J]. Hypertension, 2009, 53(5): 860-866.
[25]
Heerspink HJ, Ninomiya T, Zoungas S, et al. Effect of lowering blood pressure on cardiovascular events and mortality in patients on dialysis: a systematic review and meta-analysis of randomised controlled trials [J]. Lancet, 2009, 373(9668): 1009-1015.
[26]
Zoccali C, Mallamaci F. Cardiovascular protection by β-blockade in hypertensive haemodialysis patients: the hypertension in haemodialysis patients treated with atenolol or lisinopril (HDPAL) trial [J]. Nephrol Dial Transplant, 2014, 29(3): 483-485.
[27]
Quencer KB, Oklu R. Hemodialysis access thrombosis [J]. Cardiovasc Diagn Ther, 2017, 7(Suppl 3): S299-S308.
[28]
McCallum W, Sarnak MJ. Blood pressure target for the dialysis patient [J]. Semin Dial, 2019, 32(1): 35-40.
[29]
Hemodialysis Adequacy 2006 Work Group. Clinical practice guidelines for hemodialysis adequacy, update 2006 [J]. Am J Kidney Dis, 2006, 48(Suppl 1): S2-S90.
[30]
National Kidney Foundation. KDOQI clinical practice guideline for hemodialysis adequacy: 2015 update [J]. Am J Kidney Dis, 2015, 66(5): 884-930.
[31]
Jindal K, Chan CT, Deziel C, et al. Hemodialysis clinical practice guidelines for the Canadian Society of Nephrology [J]. J Am Soc Nephrol, 2006, 17(3 Suppl 1): S1-S27.
[32]
Hirakata H, Nitta K, Inaba M, et al. Japanese Society for Dialysis Therapy guidelines for management of cardiovascular diseases in patients on chronic hemodialysis [J]. Ther Apher Dial, 2012, 16(5): 387-435.
[33]
Davenport A, Cox C, Thuraisingham R. Achieving blood pressure targets during dialysis improves control but increases intradialytic hypotension [J]. Kidney Int, 2008, 73(6): 759-764.
[34]
SPRINT Research Group; Wright JT Jr, Williamson JD, et al. A randomized trial of intensive versus standard blood-pressure control [J]. N Engl J Med, 2015, 373(22): 2103-2116.
[35]
Cheung AK, Chang TI, Cushman WC, et al. Executive summary of the KDIGO 2021 clinical practice guideline for the management of blood pressure in chronic kidney disease [J]. Kidney Int, 2021, 99(3): 559-569.
[36]
中华医学会肾脏病学分会,中关村肾病血液净化创新联盟. 中国透析患者慢性心力衰竭管理指南[J]. 中华肾脏病杂志2022, 38(5): 465-496.
[37]
高血压肾病诊治中国专家共识组成员. 高血压肾病诊断和治疗中国专家共识(2022) [J]. 中华高血压杂志2022, 30(4): 307-317.
[1] 许杰, 李亚俊, 韩军伟. 两种入路下腹腔镜根治性全胃切除术治疗超重胃癌的效果比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 19-22.
[2] 高杰红, 黎平平, 齐婧, 代引海. ETFA和CD34在乳腺癌中的表达及与临床病理参数和预后的关系研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 64-67.
[3] 李代勤, 刘佩杰. 动态增强磁共振评估中晚期低位直肠癌同步放化疗后疗效及预后的价值[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 100-103.
[4] 屈翔宇, 张懿刚, 李浩令, 邱天, 谈燚. USP24及其共表达肿瘤代谢基因在肝细胞癌中的诊断和预后预测作用[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 659-662.
[5] 顾雯, 凌守鑫, 唐海利, 甘雪梅. 两种不同手术入路在甲状腺乳头状癌患者开放性根治性术中的应用比较[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 687-690.
[6] 付成旺, 杨大刚, 王榕, 李福堂. 营养与炎症指标在可切除胰腺癌中的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 704-708.
[7] 关小玲, 周文营, 陈洪平. PTAAR在乙肝相关慢加急性肝衰竭患者短期预后中的预测价值[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 841-845.
[8] 张润锦, 阳盼, 林燕斯, 刘尊龙, 刘建平, 金小岩. EB病毒相关胆管癌伴多发转移一例及国内文献复习[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 865-869.
[9] 陈晓鹏, 王佳妮, 练庆海, 杨九妹. 肝细胞癌VOPP1表达及其与预后的关系[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 876-882.
[10] 刘郁, 段绍斌, 丁志翔, 史志涛. miR-34a-5p 在结肠癌患者的表达及其与临床特征及预后的相关性研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 485-490.
[11] 陈倩倩, 袁晨, 刘基, 尹婷婷. 多层螺旋CT 参数、癌胚抗原、错配修复基因及病理指标对结直肠癌预后的影响[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 507-511.
[12] 曾明芬, 王艳. 急性胰腺炎合并脂肪肝患者CT 与彩色多普勒超声诊断参数与其病情和预后的关联性研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 531-535.
[13] 沈炎, 张俊峰, 唐春芳. 预后营养指数结合血清降钙素原、胱抑素C及视黄醇结合蛋白对急性胰腺炎并发急性肾损伤的预测价值[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 536-540.
[14] 王景明, 王磊, 许小多, 邢文强, 张兆岩, 黄伟敏. 腰椎椎旁肌的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 846-852.
[15] 郭曌蓉, 王歆光, 刘毅强, 何英剑, 王立泽, 杨飏, 汪星, 曹威, 谷重山, 范铁, 李金锋, 范照青. 不同亚型乳腺叶状肿瘤的临床病理特征及预后危险因素分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 524-532.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?