JASN:血液透析与血压管理!

2017-12-09 xing.T MedSci原创

虽然研究人员得到了一个可能安全的结果,但试验规模较小,持续时间较短,却无法得出明确的结论。考虑到血液透析患者主要心血管不良事件的高风险,需要进行全面的试验来评估这一人群中强化高血压控制的潜在益处。

血液透析患者的最佳的血压目标值尚不清楚。近日,肾脏病领域权威杂志Journal of the American Society of Nephrology上发表一篇研究文章,研究人员将126例高血压血液透析患者随机分为透析前收缩压为110-140mmHg(强化降压组)或155-165mmHg(标准治疗组)。

该研究的主要目的是评估治疗方案的可行性和安全性,次要目标是评估左心室质量的变化。中位随访时间为365天,在标准治疗组,两周的平均收缩压在干预期间没有明显变化,但在强化降压组,收缩压从基线的160mmHg下降至4.5个月后的143mmHg。从4到12个月,组间收缩压的平均差异为12.9mmHg。强化降压组中有四例死亡,标准治疗组中有一例死亡。强化降压组与标准治疗组相比,主要不良心血管事件、住院和血管通路血栓形成的发病率比值分别为1.18(0.40-3.33)、1.61(0.87-2.97)和3.09(0.96-8.78)。强化治疗组和标准治疗组左心室质量也有类似的中位数变化(95%可信区间)分别为-0.84(-17.1至10)和1.4(-11.6至10.4)g。

虽然研究人员得到了一个可能安全的结果,但试验规模较小,持续时间较短,却无法得出明确的结论。考虑到血液透析患者主要心血管不良事件的高风险,需要进行全面的试验来评估这一人群中强化高血压控制的潜在益处。

原始出处:

Dana C. Miskulin,et al. BP in Dialysis: Results of a Pilot Study.JASN,2017, http://jasn.asnjournals.org/content/early/2017/12/06/ASN.2017020135.abstract#aff-1

本文系梅斯医学(MedSci)原创编译整理,转载需授权!


版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1941343, encodeId=b98319413430c, content=<a href='/topic/show?id=bd2f28e0e1' target=_blank style='color:#2F92EE;'>#ASN#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2870, encryptionId=bd2f28e0e1, topicName=ASN)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1777154, createdName=chenhongpeng, createdTime=Mon May 07 08:24:00 CST 2018, time=2018-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262502, encodeId=710b126250205, content=<a href='/topic/show?id=a57589339a4' target=_blank style='color:#2F92EE;'>#血液透析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89339, encryptionId=a57589339a4, topicName=血液透析)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Mon Dec 11 05:24:00 CST 2017, time=2017-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1344311, encodeId=0af913443114c, content=<a href='/topic/show?id=683a88964b0' target=_blank style='color:#2F92EE;'>#血压管理#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88964, encryptionId=683a88964b0, topicName=血压管理)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=793a2500200, createdName=12498e5fm12(暂无昵称), createdTime=Mon Dec 11 05:24:00 CST 2017, time=2017-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268135, encodeId=b5d72681352f, content=学习了.谢谢., beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sat Dec 09 14:54:25 CST 2017, time=2017-12-09, status=1, ipAttribution=)]
    2018-05-07 chenhongpeng
  2. [GetPortalCommentsPageByObjectIdResponse(id=1941343, encodeId=b98319413430c, content=<a href='/topic/show?id=bd2f28e0e1' target=_blank style='color:#2F92EE;'>#ASN#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2870, encryptionId=bd2f28e0e1, topicName=ASN)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1777154, createdName=chenhongpeng, createdTime=Mon May 07 08:24:00 CST 2018, time=2018-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262502, encodeId=710b126250205, content=<a href='/topic/show?id=a57589339a4' target=_blank style='color:#2F92EE;'>#血液透析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89339, encryptionId=a57589339a4, topicName=血液透析)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Mon Dec 11 05:24:00 CST 2017, time=2017-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1344311, encodeId=0af913443114c, content=<a href='/topic/show?id=683a88964b0' target=_blank style='color:#2F92EE;'>#血压管理#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88964, encryptionId=683a88964b0, topicName=血压管理)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=793a2500200, createdName=12498e5fm12(暂无昵称), createdTime=Mon Dec 11 05:24:00 CST 2017, time=2017-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268135, encodeId=b5d72681352f, content=学习了.谢谢., beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sat Dec 09 14:54:25 CST 2017, time=2017-12-09, status=1, ipAttribution=)]
    2017-12-11 habb
  3. [GetPortalCommentsPageByObjectIdResponse(id=1941343, encodeId=b98319413430c, content=<a href='/topic/show?id=bd2f28e0e1' target=_blank style='color:#2F92EE;'>#ASN#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2870, encryptionId=bd2f28e0e1, topicName=ASN)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1777154, createdName=chenhongpeng, createdTime=Mon May 07 08:24:00 CST 2018, time=2018-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262502, encodeId=710b126250205, content=<a href='/topic/show?id=a57589339a4' target=_blank style='color:#2F92EE;'>#血液透析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89339, encryptionId=a57589339a4, topicName=血液透析)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Mon Dec 11 05:24:00 CST 2017, time=2017-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1344311, encodeId=0af913443114c, content=<a href='/topic/show?id=683a88964b0' target=_blank style='color:#2F92EE;'>#血压管理#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88964, encryptionId=683a88964b0, topicName=血压管理)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=793a2500200, createdName=12498e5fm12(暂无昵称), createdTime=Mon Dec 11 05:24:00 CST 2017, time=2017-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268135, encodeId=b5d72681352f, content=学习了.谢谢., beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sat Dec 09 14:54:25 CST 2017, time=2017-12-09, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1941343, encodeId=b98319413430c, content=<a href='/topic/show?id=bd2f28e0e1' target=_blank style='color:#2F92EE;'>#ASN#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2870, encryptionId=bd2f28e0e1, topicName=ASN)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1777154, createdName=chenhongpeng, createdTime=Mon May 07 08:24:00 CST 2018, time=2018-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262502, encodeId=710b126250205, content=<a href='/topic/show?id=a57589339a4' target=_blank style='color:#2F92EE;'>#血液透析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89339, encryptionId=a57589339a4, topicName=血液透析)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=19c567, createdName=habb, createdTime=Mon Dec 11 05:24:00 CST 2017, time=2017-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1344311, encodeId=0af913443114c, content=<a href='/topic/show?id=683a88964b0' target=_blank style='color:#2F92EE;'>#血压管理#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88964, encryptionId=683a88964b0, topicName=血压管理)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=793a2500200, createdName=12498e5fm12(暂无昵称), createdTime=Mon Dec 11 05:24:00 CST 2017, time=2017-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=268135, encodeId=b5d72681352f, content=学习了.谢谢., beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sat Dec 09 14:54:25 CST 2017, time=2017-12-09, status=1, ipAttribution=)]
    2017-12-09 惠映实验室

    学习了.谢谢.

    0

相关资讯

JASN:血液透析患者血清镁与髋部骨折风险之间有何关系?

由此可见,轻度高镁血症与血液透析患者较低的髋部骨折风险相关。

Kidney int:腹膜透析与血液透析相比,哪个对认知功能的改善更好?

终末期肾病患者的认知功能受损可能会降低其遵守复杂的医疗程序或饮食方案以及充分参与医疗决策的能力。随着肾功能的降低,患者的认知能力可能也下降,开始透析后认知功能的障碍可能会发生改善,肾移植成功后的患者其认识功能障碍甚至可以出现逆转。然而,目前关于这些患者的认知功能变化知之甚少,特别是关于不同的治疗方式对认知功能的影响。为了进一步了解这一点,近期,一篇发表在杂志Kidney int上的文章进行了为期一

Atherosclerosis:长期血液透析的尿毒症患者,血清总胆红素与死亡率的关系

研究表明,高水平的胆红素与长期血液透析的尿毒症患者的死亡率有关,仍然需要进一步研究非结合胆红素或结合胆红素对血液透析患者的不同作用。

2017 NICE诊断指南:多频生物电阻抗装置指导慢性肾病患者进行血液透析时的液体管理(DG.29)

2017年6月,英国国家卫生与临床优化研究所 (NICE)发布了多频生物电阻抗装置指导慢性肾病患者进行血液透析时的液体管理的诊断指南,文章评估了应用多频生物电阻抗装置指导慢性肾病患者进行血液透析时的液体管理的临床评价和效益。

27岁小伙子首次看病就查出尿毒症,难道尿毒症前没有症状吗?

有一天上午我就要下班时,一个27岁的小伙子过来说神经科的医生让他过来找我。原来他血压高,头晕,先看的神经科,做了一个脑CT没有发现问题,于是神经科医生推荐来看我的门诊。

2017 KSN临床实践指南:中东呼吸综合征血液透析治疗

感染是导致终末期肾病患者死亡的第2大常见原因,本文主要描述了在中东呼吸综合征爆发期间感染控制的经验并总结了中东呼吸综合征患者血液透析治疗指导建议。