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JASN：睡眠动态血压是CKD的独立预测指标！

2017-04-30 xing.T MedSci原创

睡眠动态血压CKD预测
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总之，睡眠时血压是CKD的一个非常重要的独立预测指标。此外，逐步治疗降低睡眠时血压可能是减少CKD风险的一个重要方法。

临床和动态血压在CKD发生上的预测价值，以及CKD风险降低是否与渐进性治疗引起的临床、清醒或睡眠血压下降有关，目前尚不明确。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，研究人员前瞻性地评估了2763例无慢性肾病参与者，其中包括1343名男性和1420名女性（平均年龄为51.5±14.3岁），这些参与者的基础动态血压范围可从正常血压到高血压。

研究人员在参与者招聘之时和每年一次（如果高血压治疗根据动态血压进行调整后，可以更频繁监测）同步监测血压、体力活动（如腕动计）48小时准确地获得个人的平均清醒、睡眠的血压。

中位随访5.9年，有404名参与者发展成CKD。在调整了年龄、糖尿病、血清肌酐、尿白蛋白浓度、既往心血管事件、高血压治疗时间的Cox比例风险模型中，平均睡眠收缩压是CKD最为显著的预测因子（觉醒 vs. 睡眠；每增加1个标准差其风险比为1.44；95%可信区间为1.31-1.56；P<0.001）。当将平均睡眠血压进行调整后，平均临床和平均觉醒的48小时动态血压预测价值并不显著。在随访期间的血压变化分析显示平均睡眠血压每降低1个标准差CKD风险减少了27%，独立于平均临床血压或觉醒血压的变化。

总之，睡眠时血压是CKD的一个非常重要的独立预测指标。此外，逐步治疗降低睡眠时血压可能是减少CKD风险的一个重要方法。

原始出处：

Ramón C. Hermida,et al. Sleep-Time Ambulatory BP Is an Independent Prognostic Marker of CKD. JASN, 2017,http://jasn.asnjournals.org/content/early/2017/04/27/ASN.2016111186.abstract

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    2017-11-01 chenhongpeng

    #ASN#

    0

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    2017-06-16 lofter

    学习了，感谢分享！

    0

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content=<a href='/topic/show?id=a7c83311e88' target=_blank style='color:#2F92EE;'>#动态血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33117, encryptionId=a7c83311e88, topicName=动态血压)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c1e10025437, createdName=limedical1977, createdTime=Tue May 02 04:27:00 CST 2017, time=2017-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192491, encodeId=8e7c192491ed, content=血压的研究有利于以后治疗, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Mon May 01 10:58:37 CST 2017, time=2017-05-01, status=1, ipAttribution=), 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    2017-06-06 1e145228m78(暂无匿称)

    学习了，谢谢作者分享!

    0

  4. 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GetPortalCommentsPageByObjectIdResponse(id=192331, encodeId=98b71923313f, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Mon May 01 00:43:18 CST 2017, time=2017-05-01, status=1, ipAttribution=)]
    2017-05-05 1e0ece0dm09(暂无匿称)

    谢谢

    0

  5. 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    2017-05-04 1ddf0692m34(暂无匿称)

    学习了

    0

  6. 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    2017-05-02 baihao215

    有意思的研究，学习了

    0

  7. 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    2017-05-02 anminleiryan

    #预测指标#

    0

  8. 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content=<a href='/topic/show?id=a7c83311e88' target=_blank style='color:#2F92EE;'>#动态血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33117, encryptionId=a7c83311e88, topicName=动态血压)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c1e10025437, createdName=limedical1977, createdTime=Tue May 02 04:27:00 CST 2017, time=2017-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192491, encodeId=8e7c192491ed, content=血压的研究有利于以后治疗, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Mon May 01 10:58:37 CST 2017, time=2017-05-01, status=1, ipAttribution=), 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    2017-05-02 limedical1977

    #动态血压#

    0

  9. 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    2017-05-01 flysky120

    血压的研究有利于以后治疗

    0

  10. 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content=<a href='/topic/show?id=a7c83311e88' target=_blank style='color:#2F92EE;'>#动态血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33117, encryptionId=a7c83311e88, topicName=动态血压)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c1e10025437, createdName=limedical1977, createdTime=Tue May 02 04:27:00 CST 2017, time=2017-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192491, encodeId=8e7c192491ed, content=血压的研究有利于以后治疗, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Mon May 01 10:58:37 CST 2017, time=2017-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192331, encodeId=98b71923313f, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Mon May 01 00:43:18 CST 2017, time=2017-05-01, status=1, ipAttribution=)]
    2017-05-01 tanxingdoctor

    学习了谢谢分享

    0

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